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

Takuya Hino; Tomoyuki Hida; Mizuki Nishino; Junwei Lu; Rachel K Putman; Elias F Gudmundsson; Akinori Hata; Tetsuro Araki; Vladimir I Valtchinov; Osamu Honda; Masahiro Yanagawa; Yoshitake Yamada; Takeshi Kamitani; Masahiro Jinzaki; Noriyuki Tomiyama; Kousei Ishigami; Hiroshi Honda; Raul San Jose Estepar; George R Washko; Takeshi Johkoh; David C Christiani; David A Lynch; Vilmundur Gudnason; Gunnar Gudmundsson; Gary M Hunninghake; Hiroto Hatabu

doi:10.1016/j.ejro.2021.100334

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

Eur J Radiol Open. 2021 Mar 10:8:100334. doi: 10.1016/j.ejro.2021.100334. eCollection 2021.

Authors

Takuya Hino¹, Tomoyuki Hida^{1

2}, Mizuki Nishino¹, Junwei Lu³, Rachel K Putman⁴, Elias F Gudmundsson⁵, Akinori Hata^{1

6}, Tetsuro Araki¹, Vladimir I Valtchinov¹, Osamu Honda⁷, Masahiro Yanagawa⁶, Yoshitake Yamada⁸, Takeshi Kamitani², Masahiro Jinzaki⁸, Noriyuki Tomiyama⁶, Kousei Ishigami², Hiroshi Honda², Raul San Jose Estepar⁹, George R Washko⁴, Takeshi Johkoh^{6

10}, David C Christiani¹¹, David A Lynch¹², Vilmundur Gudnason^{5

13}, Gunnar Gudmundsson^{13

14}, Gary M Hunninghake^{1

4}, Hiroto Hatabu¹

Affiliations

¹ Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
² Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, 8128582, Japan.
³ Department of Biostatistics, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.
⁴ Pulmonary and Critical Care Division, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
⁵ Icelandic Heart Association, Hjartavernd, Holtasmári 1, 201, Kópavogur, Iceland.
⁶ Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan.
⁷ Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan.
⁸ Department of Diagnostic Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 1608582, Japan.
⁹ Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
¹⁰ Department of Radiology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 6608511, Japan.
¹¹ Department of Environmental Health, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.
¹² Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA.
¹³ University of Iceland, Faculty of Medicine, Vatnsmyrarvegur 16, 101, Reykjavík, Iceland.
¹⁴ Department of Respiratory Medicine, Landspitali University Hospital, Fossvogur 108, Reykjavík, Iceland.

Abstract

Purpose: 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.

Results: The higher the TBI at baseline, the higher TB Progression Score (P < 0.001). All five participants with TBI = 3 at baseline progressed; 46 (90 %) of 51 participants with TBI = 2 progressed. TB progression was also associated with shorter OS with statistically significant difference (adjusted HR = 1.68, P < 0.001).

Conclusion: TB progression was visualized on chest CT frequently and clearly. It has the potential to be the predictor for poorer prognosis of ILA.

Keywords: AGES-Reykjavik Study, Age Gene/Environment Susceptibility-Reykjavik Study; Age Gene/Environment Susceptibility-Reykjavik Study; BMI, body mass index; HR, hazard ratio; ILA, interstitial lung abnormalities; ILD, interstitial lung disease; Interstitial lung abnormality; OS, overall survival; Pulmonary fibrosis; TB, traction bronchiectasis; TBI, traction bronchiectasis/bronchiolecetasis index; TBI-R2, traction bronchiectasis/bronchiolecetasis index on Round 2; Traction bronchiectasis; Usual interstitial pneumonia.

Abstract

Grants and funding