Division of Rheumatology, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Department of Radiology, University of California Los Angeles, Los Angeles, California, USA.
RMD Open. 2024 Nov 27;10(4):e004592. doi: 10.1136/rmdopen-2024-004592.
To explore the association between the extent of CT abnormalities by quantitative imaging analysis (QIA) and clinical/physiological disease parameters in patients with antisynthetase syndrome associated interstitial lung disease (ARS-ILD).
We analysed 20 patients with antisynthetase antibodies and active ILD enrolled in the Abatacept in Myositis-Associated Interstitial Lung Disease study. High-resolution chest CT was obtained at weeks 0, 24 and 48 and QIA scored the extent of ground glass (quantitative score for ground glass), fibrosis (quantitative score for lung fibrosis, QLF) and total ILD (quantitative ILD, QILD). Mixed-effects models estimated longitudinal QIA scores over time. Associations between QIA scores with clinical/physiological parameters were analysed longitudinally using repeated-measures mixed-effects models.
Patients were median age 57 years, 55% males and 85% white. Higher (worse) baseline QIA scores correlated with lower baseline forced vital capacity (FVC) and diffusing capacity adjusted for haemoglobin (DLCO). Longitudinal QIA trajectories trended towards improving scores during the trial, and patients on O at baseline had worsening QIA trajectories which were different from patients who were not on O. Longitudinal QIA scores demonstrated strong associations with both FVC and DLCO over time. Higher QILD scores over time were also associated with worse dyspnoea scores, pulmonary visual analogue scale, physician and patient global disease activity, health status in 6/8 domains of the Short Form-36 and higher oxygen requirements. Patients with significant radiographic improvement at 48 weeks had higher baseline QLF, QILD and worse DLCO.
Longitudinal QIA scores associate with lung physiology, patient perception of respiratory status, overall disease activity and quality of life over time in ARS-ILD. QIA may allow reproducible monitoring of disease progression and response to therapy over time.
NCT03215927.
探讨定量成像分析（QIA）所显示的 CT 异常程度与抗合成酶综合征相关间质性肺病（ARS-ILD）患者的临床/生理疾病参数之间的关系。
我们分析了 20 例抗合成酶抗体阳性且有活动性间质性肺病的患者，这些患者均来自 Abatacept 在肌炎相关性间质性肺病研究中。在第 0、24 和 48 周时获得高分辨率胸部 CT，并使用 QIA 对磨玻璃影（磨玻璃定量评分）、纤维化（肺纤维化定量评分，QLF）和总间质性肺病（定量间质性肺病，QILD）的程度进行评分。混合效应模型估计 QIA 评分随时间的纵向变化。使用重复测量混合效应模型分析 QIA 评分与临床/生理参数之间的纵向相关性。
患者的中位年龄为 57 岁，55%为男性，85%为白人。基线时 QIA 评分越高（越差），则基线用力肺活量（FVC）和血红蛋白校正后的弥散量（DLCO）越低。在试验过程中，QIA 轨迹呈改善趋势，而基线时使用 O 的患者的 QIA 轨迹恶化，与未使用 O 的患者不同。随着时间的推移，QIA 评分与 FVC 和 DLCO 之间呈强烈关联。随着时间的推移，QILD 评分越高，呼吸困难评分、肺视觉模拟量表、医生和患者的整体疾病活动度、健康状态在 8 个领域中的 6 个领域以及更高的氧气需求也越差。48 周时影像学有显著改善的患者基线时 QLF、QILD 较高，DLCO 较差。
在 ARS-ILD 中，QIA 的纵向评分与肺生理学、患者对呼吸状况的感知、整体疾病活动度和随时间变化的生活质量相关。QIA 可能允许在一段时间内对疾病进展和治疗反应进行可重复的监测。
NCT03215927。
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