Prediction of IPF Progression Using HRCT Imaging Patterns in Elderly Population

Abstract

Rationale: Idiopathic Pulmonary Fibrosis (IPF) is a progressive lung disease that affects individuals aged 50 to 75 years with median survival of 2-5 years. High Resolution Computed Tomography (HRCT) play an important role in diagnosis of IPF. Previously, a Quantitative Lung Fibrosis (QLF) score that measures fibrotic patterns on HRCT has been developed (Kim et al Clin Exp Rheumatol. 2010). The aim of study is to investigate whether quantitative imaging phenotypes can predict progression in the elderly population. Methods: Among 253 subjects with anonymized HRCT images from retrospective studies, 164 subjects had both clinical and imaging data available. Using a 4% threshold for changes in QLF at the most severe lobe as a proxy of minimal clinically important difference in IPF population, study population was compared. Progression was defined as a 10% decline in FVC from baseline. Log rank test and the landmark Cox regressions were used to compare the progression with the early quantitative radio-graphical changes ( Results: The risk of progression is statistically different among the four groups (p=0.0012). Subjects who had large QLF changes or/and were ≥ 65 years old had approximately a 2 fold increase in the risk of progression (HZ=2.4, p Conclusions: Early quantitative changes on HRCT in elderly population potentially can play a role in patient’s management in efficacious treatments and monitoring.