Reporting of coronary artery calcification on chest CT studies in patients with Interstitial Lung Disease.

Abstract Background Chest computed tomography (CT) findings in well-treated people with HIV infection (PWH) remain poorly characterized. Methods Cross-sectional analysis examining interstitial chest CT findings in PWH (n = 754) and uninfected controls (n = 470). Results HIV infection was independently associated with 1.82 (95% CI, 1.18–2.88) and 5.15 (95% CI, 1.72–22.2) higher adjusted odds of any interstitial lung abnormality and findings suspicious for interstitial lung disease, respectively. Conclusions HIV infection was independently associated with interstitial lung abnormalities and findings suspicious for interstitial lung disease. Whether these abnormalities develop into more recognizable disease states over time is unknown but warrants further investigation.

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Pre-existing interstitial lung disease is associated with onset of nivolumab-induced pneumonitis in patients with solid tumors: A retrospective analysis

10.21203/rs.2.18450/v1 ◽

2019 ◽

Author(s):

Teppei Yamaguchi ◽

Junichi Shimizu ◽

Takaaki Hasegawa ◽

Yoshitsugu Horio ◽

Yoshitaka Inaba ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Lung Disease ◽

Solid Tumors ◽

Odds Ratio ◽

Malignant Tumors ◽

Checkpoint Inhibitors ◽

Patient Characteristics ◽

Chest Ct ◽

Life Threatening ◽

Male Sex

Abstract BackgroundNivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody, has shown survival benefit in clinical trials of various malignant tumors. Nivolumab-induced pneumonitis is major immune-related adverse event (irAE) that is occasionally serious and life-threatening. The aim of this study was to examine the association between pre-existing interstitial lung disease (ILD) on chest computed tomography (CT) and nivolumab-induced pneumonitis among different types of solid tumors.MethodsWe retrospectively collected the clinical data of 311 patients who were diagnosed with non-small cell lung cancer (NSCLC), head and neck cancer (HNC), or gastric cancer (GC), and treated with nivolumab monotherapy. Patients who underwent chest CT immediately before starting nivolumab without previous thoracic radiotherapy or other immune checkpoint inhibitors were eligible. We collected baseline patient characteristics and assessed pre-existing ILD on baseline chest CT.ResultsFinally, 188 patients were included in the analysis: 96 patients with NSCLC, 43 patients with HNC, and 49 patients with GC. NSCLC patients had a significantly higher rate of pre-existing ILD compared with HNC/GC patients (P=0.047). Nivolumab-induced pneumonitis occurred in 11.7% (22 of 188), including 14.6% (14 of 96) of NSCLC, and 8.7% (8 of 92) of HNC/GC. Univariate and multivariate logistic regression analyses revealed that pre-existing ILD (odds ratio, 5.92; 95% confidence interval (CI), 2.07–18.54, P=0.0008) and male sex (odds ratio, 5.58; 95% CI, 1.01–104.40, P=0.049) significantly increased the risk of nivolumab-induced pneumonitis.ConclusionOur results indicated that pre-existing ILD and male sex are risk factors for nivolumab-induced pneumonitis in solid tumors.

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AB0624 PREDICTIVE PARAMETERS FOR DEVELOPMENT OF INTERSTITIAL LUNG DISEASE IN IDIOPATHIC INFLAMMATORY MYOSITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3571 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1607.2-1607

Author(s):

T. Vojinovic ◽

M. Fredi ◽

P. Ceruti ◽

D. Modina ◽

F. Franceschini ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Lung Disease ◽

Interstitial Pneumonia ◽

Chest Ct ◽

The Other ◽

Inflammatory Myositis ◽

Idiopathic Inflammatory Myositis ◽

X Ray ◽

Other Hand ◽

Chest X Ray

Background:Idiopathic Inflammatory Myositis (IIM) is a group of heterogeneous connective tissue diseases, primarily characterized by chronic muscle inflammation as well as myositis-specific or myositis-associated autoantibodies and a spectrum of different extra-muscular features.The most frequent organ involment in IIM is Interstitial Lung Disease (ILD), occurring in 5-80% of different IIMs cases and considered the hallmark of morbidity and mortality in patients with IIMs.Objectives:To retrospectively assess the predictive factors for development of ILD in IIM patientsMethods:We retrospectively analyzed the prevalence of ILD in a single-center cohort of 165 IIM patients. Patient data was collected from clinical charts. ILD was diagnosed by chest X-ray scan and chest CT scan. All chest CT and chest X-ray scans available and performed at our hospital were consequently re-evaluated by our expert pneumologist for uniform evaluation.Results:Myositis-related ILD (M-ILD) was found in 52 IIM patients (31.5%): 46.15% was affected by anti-synthetase syndrome (ARS), 21.15% by polymyositis (PM), 19.23% by dermatomyositis (DM) and 13.46% by overlap myositis. The pulmonary involvement was characterized by Non-specific interstitial pneumonia (NSIP) (30.6%), Unusual Interstitial Pneumonia (UIP) (38.77%), Bronchiolitis Obliterans with Organizing Pneumonia (BOOP) (20.4%), overlap NSIP/BOOP (4.1%) and Undetermined/Unspecific pattern (6.12%). Eighty four percent of M-ILD consisted of non-smokers and 69.23% presented with dyspnea at onset.ILD was diagnosed in 90.38% of patients within the first year of IIM diagnosis (early onset ILD) and was associated with dyspnea and/or cough in 70.2% and 17% respectively. On the other hand, late onset ILD presented mostly with dyspnea and/or cough in 60% of cases and was significantly associated with anti-Ku antobodies.At onset ILD was significantly associated with: ARS (p<0.0001; OR:12.98), anti-Jo-1 (p<0.0001; OR:6.1), anti-Ro (p=0.038; OR:2.2), mechanic’s hands (p<0.0001; OR:10.41), arthritis (p=0.01; OR:2.58), polyarthritis (p=0.001; OR:4.578), dyspnea (p<0.0001; OR:9.66), and high levels of CPK (p=0.0001) and GOT (p=0.0146). By contrast, the following features: DM (p=0.012; OR:0.36), facial rash (p=0.003; OR:0.31), anti-NXP-2 (p=0.019; OR<0.0001), anti-PL-12 (p=0,03; OR<0.0001) and myositis (p<0.0001; OR:0.173) present at onset were less frequently associated with M-ILD.At multivariate analysis M-ILD was predicted by anti-Ro (p=0.0448), polyarthritis (p=0.0093) and dyspnea (p=0.0001) at onset. On the other hand, patients presenting myositis (p=0.0383) and facial rash (p=0.0398) at onset were less likely to developed M-ILD.Conclusion:ILD occurs in about one third of patients with IIM, mostly affected by ARS. The presence of anti-Ro antibodies as well as polyarthritis and dyspnea at onset predict the development of ILD.Disclosure of Interests:None declared

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Prognostic effects of clinical and CT imaging features on critically ill patients with interstitial lung disease hospitalized in respiratory intensive care unit

Scientific Reports ◽

10.1038/s41598-019-53865-0 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Shenyun Shi ◽

Yonglong Xiao ◽

Xiaohua Qiu ◽

Yan Li ◽

Yuying Qiu ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Critically Ill ◽

Critically Ill Patients ◽

Chest Ct ◽

Imaging Features ◽

Significant Difference ◽

Respiratory Intensive Care Unit

AbstractThe study aimed to evaluate the clinical and imaging features of critically ill patients with interstitial lung disease (ILD) treated in respiratory intensive care unit (RICU) and assess the prognostic effects of these factors. A total of 160 severe ILD patients admitted to the RICU were finally enrolled in this study. The clinical, imaging and follow-up data of them were studied retrospectively. The in-hospital mortality and total mortality were 43.1% and 63.8% respectively. By multivariate cox regression analysis, shock (OR = 2.39, P = 0.004), pulmonary fibrosis on CT (OR = 2.85, P = 0.002) and non-invasive ventilation (OR = 1.86, P = 0.037) were harmful factors to survivals of critically ill patients with ILD. In contrast, oxygenation index (OR = 0.99, P = 0.028), conventional oxygen therapy (OR = 0.59, P = 0.048) and β-lactam antibiotics use (OR = 0.51, P = 0.004) were protective factors. There is significant difference of survivals between patients with and without fibrosing ILD on CT (Log-rank, p = 0.001). The prognosis of critically ill patients with ILD was poor. Shock, respiratory failure and fibrosing signs on chest CT affected the prognosis. Chest CT was considered as a valuable tool to indicate the prognosis.

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Coronary artery calcification identification and labeling in low-dose chest CT images

10.1117/12.2254125 ◽

2017 ◽

Cited By ~ 2

Author(s):

Yiting Xie ◽

Shuang Liu ◽

Albert Miller ◽

Jeffrey A. Miller ◽

Steven Markowitz ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Calcification ◽

Low Dose ◽

Ct Images ◽

Chest Ct

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The role of high-resolution chest CT in the diagnosis of neuroendocrine cell hyperplasia of infancy – A rare form of pediatric interstitial lung disease

Respiratory Medicine Case Reports ◽

10.1016/j.rmcr.2015.09.001 ◽

2015 ◽

Vol 16 ◽

pp. 101-103 ◽

Cited By ~ 2

Author(s):

Julia Lee ◽

Thomas Ray Sanchez ◽

Yanhong Zhang ◽

Sanjay Jhawar

Keyword(s):

High Resolution ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Chest Ct ◽

Neuroendocrine Cell ◽

Rare Form ◽

Cell Hyperplasia ◽

Pediatric Interstitial Lung Disease

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POS0863 DIFFERENTIATING THE DOMINANCE OF PULMONARY VASCULAR DISEASE OR INTERSTITIAL LUNG DISEASE ON HEMODYNAMIC ABNORMALITIES IN SYSTEMIC SCLEROSIS AND CLARIFYING EACH CHARACTERISTIC BY USING QUANTITATIVE EVALUATION OF CHEST CT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2569 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 687.1-687

Author(s):

K. Ninagawa ◽

M. Kato ◽

M. Kono ◽

Y. Fujieda ◽

K. Oku ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Systemic Sclerosis ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Quantitative Evaluation ◽

Lung Volume ◽

Chest Ct ◽

Normal Lung ◽

Pulmonary Vascular Disease ◽

Group 1

Background:Group 1 and 3 pulmonary hypertension (PH) develop through different pathological mechanisms but have similar hemodynamic abnormalities. Systemic sclerosis (SSc) is associated with both pulmonary vascular disease (PVD) and interstitial lung disease (ILD), making it challenging to differentiate group 1 and 3 PH in those patients. A previous study using quantitative evaluation of chest computed tomography (CT) demonstrated that normal lung volume was inversely correlated with mean pulmonary arterial pressure (mPAP) in patients with group 3 PH (1).Objectives:In this study, we aimed to assess the dominance of PVD or ILD in SSc patients by quantitative evaluation of chest CT and to evaluate each characteristic.Methods:A total of 76 SSc patients who underwent right heart catheterization (RHC) were included. Chest CT was evaluated by using a software (Synapse Vincent Ver.3.0, Fujifilm) which quantified normal and total area of the lung. Then, we calculated abnormal area by drawing normal area from total area in the lung (%). Pulmonary function test (PFT) and serum biomarkers, such as KL-6 and LDH, were also evaluated. The dominance of PVD or ILD was defined as divergent or parallel change between the first and last assessments, respectively, in mPAP and abnormal area in the lung calculated using the software. Increase or decrease by over 10% in the last assessment compared to the first assessment was considered as a significant change in mPAP or abnormal area in the lung. P values were calculated by Mann-Whitney U test, and correlation coefficients were calculated by direct regression variance.Results:The median [range] values of mPAP and abnormal area in the lung at baseline were 23 [9-65] mmHg and 30.2 [0-100] %, respectively. Of 37 SSc and PH patients, 18 were defined as having PVD dominance while 19 as ILD dominance. Abnormal area in the lung at baseline was greater in patients with ILD dominance compared to those with PVD dominance (39.1 [16.3-98.3] v.s. 14.0 [0-99] %, p=0.002), whereas mPAP was higher in patients with PVD dominance than those with ILD dominance (42.5 [23.0-65.0] v.s. 26.0 [16.0-42.0] mmHg, p=0.002). PFT parameters including forced vital capacity were not different between the two groups. The ratio of mPAP/KL-6 showed a great difference between the two groups with its significant elevation in patients with PVD dominance (p=0.007).Conclusion:Quantitative evaluation of chest CT showed great efficiency in differentiating the dominance of PVD or ILD in patients with SSc and PH. In addition, the ratio of mPAP/KL-6 may easily be used as a parameter for dominance evaluation.References:[1]Iwasawa T, Kato S, Ogura T, Kusakawa Y, Iso S, Baba T, et al. Low-normal lung volume correlates with pulmonary hypertension in fibrotic idiopathic interstitial pneumonia: computer-aided 3D quantitative analysis of chest CT. AJR Am J Roentgenol. 2014;203(2):W166-73.Disclosure of Interests:None declared

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POS0264 THE EMERGING ROLE OF MAGNETIC RESONANCE IMAGING IN INTERSTITIAL LUNG DISEASE IN SYSTEMIC SCLEROSIS: EVIDENCE FOR ULTRA SHORT TE AND COMPRESSED SENSING VIBE ACQUISITIONS AS PROMISING TOOLS FOR THE EVALUATION OF PARENCHYMAL ALTERATIONS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3253 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 355.1-355

Author(s):

N. Landini ◽

M. Orlandi ◽

M. Occhipinti ◽

C. Nardi ◽

L. Tofani ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Systemic Sclerosis ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Sensitivity And Specificity ◽

Chest Ct ◽

Resonance Imaging ◽

Mri Sequences ◽

Good Concordance

Background:Interstitial lung disease (ILD) is a frequent complication and the major cause of death in Systemic sclerosis (SSc). Computed tomography (CT) is the gold standard imaging technique to assess ILD but is burdened by exposure to ionizing radiations that limits its use for the follow-up. MRI sequences with Ultra Short Echo Time (UTE) are promising for ILD.Objectives:We tested two MRI sequences, UTE Spiral VIBE and Compressing Sensing (CS) VIBE, in SSc-ILD, in comparison to chest CT.Methods:SSc patients with suspected-ascertained ILD were evaluated for undergoing CT-MRI examinations in the same day. Two radiologists visually scored the extent of ground glass opacities (GGO), reticulations, honeycombing and consolidations on CT-MRI. The sum of alteration was assumed as ILD extent. A quantitative texture analysis (qCT) was also performed on CT. Cohen’s k was adopted for interreader concordance in ILD detection. MRI sensitivity and specificity in ILD detection were evaluated. Lin’s concordance was adopted to compare extent analysis between readers and between CT (visual and qCT analysis) and MRI sequences.Results:54 patients performed both CT and MRI. MRI interreader concordance was moderate in ILD detection, while ILD and GGO extent analysis showed good or very good concordance. UTE Spiral VIBE had a sensitivity and specificity in ILD detection of 95.8% and 77.8%, while alterations extent analysis obtained a very good concordance with CT for ILD and GGO. CS VIBE showed a sensitivity and specificity in ILD detection of 46.7% and 95.0%, but a slight or fair concordance with CT in all alterations’ extent analysis.Conclusion:MRI UTE Spiral VIBE sequences are helpful in the evaluation of SSc-ILD. Larger cohorts of patients will be needed to confirm that MRI may be useful in clinical practice, reducing the radiological load of chest CTReferences:[1]Romei C, Turturici L, Tavanti L, et al. The use of chest magnetic resonance imaging in interstitial lung disease: a systematic review. Eur Respir Rev. 2018;27(150):180062. Doi:10.1183/16000617.0062-2018[2]Miller GW, Mugler JP, Sá RC, Altes TA, Prisk GK, Hopkins SR. Advances in functional and structural imaging of the human lung using proton MRI. NMR Biomed. 2014;27(12):1542-1556. doi:10.1002/nbm.3156[3]Pinal-Fernandez I, Pineda-Sanchez V, Pallisa-Nuñez E, et al. Fast 1.5 T chest MRI for the assessment of interstitial lung disease extent secondary to systemic sclerosis. Clin Rheumatol. 2016;35(9):2339-2345. doi:10.1007/s10067-016-3267-0[4]Ohno Y, Koyama H, Yoshikawa T, et al. Pulmonary high-resolution ultrashort TE MR imaging: Comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases: Pulmonary MRI with UTE in Pulmonary Disease. J Magn Reson Imaging. 2016;43(2):512-532. doi:10.1002/jmri.25008Disclosure of Interests:None declared

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Pitfalls in diagnosis of infiltrative lung disease by CT

BJR|Open ◽

10.1259/bjro.20190036 ◽

2019 ◽

Vol 1 (1) ◽

pp. 20190036

Author(s):

Céline Du Pasquier ◽

Rami Hajri ◽

Romain Lazor ◽

Cécile Daccord ◽

Stacey Gidoin ◽

...

Keyword(s):

Differential Diagnosis ◽

Interstitial Lung Disease ◽

Lung Disease ◽

False Positive ◽

Chest Ct ◽

Post Processing ◽

Clinical Context ◽

Technical Aspects ◽

Ct Examination ◽

Satisfaction Of Search

The diagnosis of interstitial lung disease may be challenging, especially in atypical disease. Various factors must be considered when performing and reading a chest CT examination for interstitial lung disease, because each of them may represent a source of misinterpretation. Firstly, technical aspects must be mastered, including acquisition and reconstruction parameters as well as post-processing. Secondly, mistakes in interpretation related to the inaccurate description of predominant features, potentially leading to false-positive findings, as well as satisfaction of search must be avoided. In all cases, clinical context, coexisting chest abnormalities and previous examinations must be integrated into the analysis to suggest the most appropriate differential diagnosis.

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