Progression of traction bronchiectasis/bronchiolectasis in interstitial lung abnormalities is associated with increased all-cause mortality: Age Gene/Environment Susceptibility-Reykjavik Study

Abstract

The aim of this study is to assess the role of traction bronchiectasis/bronchiolectasis and its progression as a predictor for early fibrosis in interstitial lung abnormalities (ILA). Methods: Three hundred twenty-seven ILA participants out of 5764 in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study who had undergone chest CT twice with an interval of approximately five-years were enrolled in this study. Traction bronchiectasis/bronchiolectasis index (TBI) was classified on a four-point scale: 0, ILA without traction bronchiectasis/bronchiolectasis; 1, ILA with bronchiolectasis but without bronchiectasis or architectural distortion; 2, ILA with mild to moderate traction bronchiectasis; 3, ILA and severe traction bronchiectasis and/or honeycombing. Traction bronchiectasis (TB) progression was classified on a five-point scale: 1, Improved; 2, Probably improved; 3, No change; 4, Probably progressed; 5, Progressed. Overall survival (OS) among participants with different TB Progression Score and between the TB progression group and No TB progression group was also investigated. Hazard radio (HR) was estimated with Cox proportional hazards model.

Biomarkers for Interstitial Lung Abnormalities: A Stepping-stone Toward Idiopathic Pulmonary Fibrosis Prevention?

“…Second, not all ILAs appear to confer equal risk for development of ILD. Certain imaging features such as honeycombing seem to be more often associated with progressive disease; however, accurate prediction of which individuals will develop IPF or PFF remains limited ( 1 , 7 ). Third, an important prerequisite to running clinical trials in individuals with ILA is the development of appropriate endpoints.…”

Interstitial lung abnormalities – current knowledge and future directions

“…In terms of imaging patterns, the definite fibrosis pattern, and both probable and definite UIP patterns are strongly associated with ILA progression [ 14 , 50 ]. Distinct features such as subpleural reticular markings, non-emphysematous cysts, changes predominantly in the lower lobe, and traction bronchiectasis are themselves associated with progression and progression of traction bronchiectasis is associated with poorer survival among those with ILA [ 50 , 75 ]. As with ILA odds in general, pruning of pulmonary vessels on CT is linked with greater odds of progression [ 23 ].…”

Computed Tomography–Based Deep Learning Model for Assessing the Severity of Patients With Connective Tissue Disease–Associated Interstitial Lung Disease

“…Vision-based semiquantitative methods are subjective and time-consuming; substantial interobserver and intraobserver variability have been reported, which may affect disease management for ILD. [10][11][12] Quantitative computed tomography (CT) analysis mainly consists of density histograms and CT threshold measurements. Still, neither can display CT morphologies of ILD, such as ground glass opacities (GGOs), reticulation, and honeycombing, nor describe the spatial distribution of lesions.…”