ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 742

Quantitative CT Evalutation in Diffuse Interstitial Lung Involvement in Systemic Sclerosis: Usefulness of Lung Texture Analysis to Predict the Functional Change over Time

Silvia Bosello1, Maria Elena Occhipinti2, Giovanni Canestrari1, Enrico De Lorenzis1, Federico Parisi1, Gerlando Natalello3, Grazia Leuconeo4, Anna Rita larici4, Chiara De Waure4, Gianfranco Ferraccioli5 and Elisa Gremese6, 1Division of Rheumatology, Università Cattolica - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy, 2University of Florence, Florence, Italy, 3Division of Rhematology, Università Cattolica - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy, 4Università Cattolica - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy, 5Institute of Rheumatology, Università Cattolica - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy, 6Division of Rheumatology - Institute of Rheumatology and Affine Sciences, Università Cattolica - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Sunday, November 5, 2017

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Clinical Aspects and Therapeutics Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

The prognosis of patients with scleroderma and interstitial lung involvement (SSc-ILD) can be evaluated by combining data of pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT), but both methods have intrinsic limitations. An automated system able to define the extent and pattern of lung parenchyma involvement could be very useful in clinical practice.

We aimed to evaluate the performance of such an automated system (CALIPER, Imbio LLC, MN) (1-2) in patients with SSc-ILD together with PFTs parameters and visual scoring of HRCT scans according to Goh’s visual reader based score (3). Moreover, we aimed to evaluate the prognostic value of CALIPER with respect to PFTs changes over time.

Methods:

Thirty-five scleroderma patients with ILD-SSc were consecutively enrolled. PFTs as well as lung HRCT were performed at both baseline and at latest follow-up. Quantitative analysis of parenchymal involvement on HRCT was performed by using CALIPER, which provided data on the relative volume of 5 different parenchymal patterns: normal, ground-glass, reticular, hyperlucent and honeycombing. Semi-quantitative analysis of the CT scans was performed by two radiologists according to the Goh’s visual reader based score.

Results:

Quantitative evaluation by CALIPER was successful in 31/35 patients (88.57%), requiring 20 m’ to 30 m’ per patient for the sofware. The two most common patterns were ground-glass (16.64%) and reticular (4.48%), with a mean disease extent of 18.8% and a prevalent distribution at middle and lower zones and in peripheral areas.

The correlations between PFTs and the relative volume of ground-glass were good (FVC: r=-0.72, p<0.001; TLC: r=-0.74, p<0.001; DLCO: r=-0.40, p=0.001), whereas PFTs and the relative volume of reticular pattern showed weaker correlations (FVC: r=-0.38, p=0.003; TLC: r=-0.42, p=0.02; DLCO: r=-0.31, p=0.02). The relative volume of normal lung had good correlations with FVC (r=0.63, p<0.001) and TLC (r=0.42, p=0.02).

The concordance between analysis performed by CALIPER and the Goh’s visual score was weak either in the ground-glass pattern (ICC:0.67, CI95%: 0.50-0.78) or in the reticular pattern (ICC:0.27, CI95%: 0.03-0.48).

Patients were followed-up for 26.0±15.6 months. Considering as clinically relevant a decrease in FVC greater than 10% or a decrease in FVC between 5-10% together with a decrease in DLco greater than 15%, reductions of lung volumes higher than -7.2 could predict a functional worsening with a sensitivity of 81% and a specificity of 70% (ROC curve analysis: AUC: 0.74, 0.54-0.93, p=0.035).

Conclusion:

Quantitative analysis performed by CALIPER arose as a useful tool to determine the extent and disease pattern in patients with SSc-ILD, correlating with PFT. The discriminatory performance of such an automated program to identify patients who presented a worsening of lung function suggests that quantitative analysis can help in evaluating response to therapy in scleroderma patients with ILD.

  1. Maldonado F, Eur Respir J 2014; 43: 204–212
  2. Bartholmai Brian J. J Thorac Imaging. 2013 September ; 28(5)
  3. Goh NSL, Am J Respir Crit Care Med. 2008;177(11):1248–54.
Disclosure: S. Bosello, None; M. E. Occhipinti, None; G. Canestrari, None; E. De Lorenzis, None; F. Parisi, None; G. Natalello, None; G. Leuconeo, None; A. R. larici, None; C. De Waure, None; G. Ferraccioli, None; E. Gremese, None.

To cite this abstract in AMA style:

Bosello S, Occhipinti ME, Canestrari G, De Lorenzis E, Parisi F, Natalello G, Leuconeo G, larici AR, De Waure C, Ferraccioli G, Gremese E. Quantitative CT Evalutation in Diffuse Interstitial Lung Involvement in Systemic Sclerosis: Usefulness of Lung Texture Analysis to Predict the Functional Change over Time [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/quantitative-ct-evalutation-in-diffuse-interstitial-lung-involvement-in-systemic-sclerosis-usefulness-of-lung-texture-analysis-to-predict-the-functional-change-over-time/. Accessed .

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