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Abstract Number: 1567

Deep-learning analysis of HRCT images predicts progression and mortality in systemic sclerosis-related interstitial lung disease

Enrico De Lorenzis1, Rosa D'Abronzo2, Pier Giacomo Cerasuolo3, Lucio Calandriello4, Gabriella Alonzi3, Giuseppe Cicchetti2, gerlando Natalello3, Bruno Iovene5, Lucia Lanzo3, Francesco Varone6, Giacomo Sgalla7, Luca Richeldi8, anna Rita Larici4, Maria Antonietta D'Agostino3 and Silvia Laura Bosello9, 1Catholic University of the Sacred Heart, Roma, Rome, Italy, 2Division of Radiology - Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy, 3Division of Rheumatology and Clinical Immunology - Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, 4Division of Radiology - Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, 5Division of Rheumatology - Catholic University of the Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Rome, Italy, 6Division of Respiratory Medicine - Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, 7Catholic University of the Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Rome, Italy, 8Division of Respiratory Medicine - Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy, 9Division of Rheumatology and Clinical Immunology - Catholic University of the Sacred Heart, Rome, Italy, Rome, Italy

Meeting: ACR Convergence 2025

Keywords: Computed tomography (CT), interstitial lung disease, Mortality, Systemic sclerosis

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Session Information

Date: Monday, October 27, 2025

Title: (1553–1591) Systemic Sclerosis & Related Disorders – Clinical Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Interstitial lung disease (ILD) is a major complication in systemic sclerosis (SSc) patients, associated with substantial morbidity and mortality. Functional, imaging, and clinical measures of lung involvement could be biased in SSc due to its multiorgan nature and extra-articular involvement (e.g., cardiac, musculoskeletal). Artificial intelligence (AI) reading of high-resolution computed tomography (HRCT) has emerged as a novel tool for the objective and reliable assessment of pulmonary diseases. The aim of this study is to correlate AVIEW measures, an Deep learning based software for HRCT image assessment, with ILD-progression and disease-related mortality in SSc patients.

Methods: The AVIEW software (Coreline Soft, South Korea) was employed to analyze HRCT images from a cohort of consecutive SSc-ILD patients at baseline and after 24±3 months. Quantitative analyses included lung volume, texture, airways, and vascular anatomy. Baseline metrics were assessed for their association with ILD progression, defined by clinical, functional, and imaging criteria based on the INBUILD study parameters over 24 months. Furthermore, changes in AVIEW-derived measurements between consecutive HRCT evaluations over the 24-month period were analyzed for their association with SSc-related mortality during the subsequent 36 months. All absolute measurements were normalized to body surface area.

Results: A total of 146 HRCT scans from 73 SSc-ILD patients were assessed (mean age 58.4±14.3 years; male 16.4%; diffuse skin variant 49.3%). Thirty-one patients (42.4%) experienced ILD progression, which was predicted at baseline by higher percentages of ground glass opacities (GGO) (p=0.05) and reticulation (p=0.05), higher subpleural vessel volumes (p=0.017), and a tendency toward larger distal airways (p=0.066). Serial evaluations demonstrated that INBUILD progression was associated with a reduction in the percentage of normal lung (p=0.044) and absolute volumes (p=0.009), without significant changes in reticulation, GGO, vessels, or airways when considered individually.Twelve patients died due to SSc within 36 months following the second HRCT evaluation. Patients in the upper quartile for changes in reticular score and airway volume exhibited a higher mortality risk, independent of INBUILD progression (reticular score: OR 3.30, 95% CI 1.03–10.61, p=0.045; airway volume: OR 3.37, 95% CI 1.08–10.51, p=0.036).

Conclusion: Deep learning-based assessment in SSc-ILD identified distinct modifications and prognostic significance in lung anatomical components, offering potential improvements in patient evaluation and stratification beyond conventional clinical tools.


Disclosures: E. De Lorenzis: None; R. D'Abronzo: None; P. Cerasuolo: None; L. Calandriello: None; G. Alonzi: None; G. Cicchetti: None; g. Natalello: None; B. Iovene: None; L. Lanzo: None; F. Varone: None; G. Sgalla: None; L. Richeldi: None; a. Larici: None; M. D'Agostino: Bristol-Myers Squibb(BMS), 5; S. Bosello: None.

To cite this abstract in AMA style:

De Lorenzis E, D'Abronzo R, Cerasuolo P, Calandriello L, Alonzi G, Cicchetti G, Natalello g, Iovene B, Lanzo L, Varone F, Sgalla G, Richeldi L, Larici a, D'Agostino M, Bosello S. Deep-learning analysis of HRCT images predicts progression and mortality in systemic sclerosis-related interstitial lung disease [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/deep-learning-analysis-of-hrct-images-predicts-progression-and-mortality-in-systemic-sclerosis-related-interstitial-lung-disease/. Accessed .
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