Performance of a new quantitative computed tomography index for interstitial lung disease assessment in systemic sclerosis

Sci Rep. 2019 Jul 1;9(1):9468. doi: 10.1038/s41598-019-45990-7.

Abstract

Quantitative high resolution computed tomography (HRCT) may objectively assess systemic sclerosis (SSc)-interstitial lung disease (ILD) extent, using three basic densitometric measures: mean lung attenuation (MLA), skewness, and kurtosis. This prospective study aimed to develop a composite index - computerized integrated index (CII) - that accounted for MLA, skewness, and kurtosis by means of Principal Component Analysis over HRCTs of 83 consecutive SSc subjects, thus eliminating redundancies. Correlations among CII, cardiopulmonary function and immune-inflammatory biomarkers (e.g. sIL-2Rα and CCL18 serum levels) were explored. ILD was detected in 47% of patients at visual HRCT assessment. These patients had worse CII values than patients without ILD. The CII correlated with lung function at both baseline and follow-up, and with sIL-2Rα and CCL18 serum levels. The best discriminating CII value for ILD was 0.1966 (AUC = 0.77; sensitivity = 0.81 [95%CI:0.68-0.92]; specificity = 0.66 [95%CI:0.52-0.80]). Thirty-four percent of patients without visual trace of ILD had a CII lower than 0.1966, and 67% of them had a diffusing lung capacity for CO <80% of predicted. We showed that this new composite CT index for SSc-ILD assessment correlates with both lung function and immune-inflammatory parameters and could be sufficiently sensitive for capturing early lung density changes in visually ILD-free patients.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Chemokines, CC / blood*
  • Female
  • Humans
  • Interleukin-2 Receptor alpha Subunit / blood*
  • Lung Diseases, Interstitial* / blood
  • Lung Diseases, Interstitial* / diagnostic imaging
  • Lung* / diagnostic imaging
  • Lung* / metabolism
  • Male
  • Middle Aged
  • Scleroderma, Systemic* / blood
  • Scleroderma, Systemic* / diagnostic imaging
  • Tomography, X-Ray Computed*

Substances

  • CCL18 protein, human
  • Chemokines, CC
  • IL2RA protein, human
  • Interleukin-2 Receptor alpha Subunit