Diagnostic Accuracy of Chest Radiography for Detecting Fibrotic Interstitial Lung Disease

Ghodrati, Sahand; Pugashetti, Janelle Vu; Kadoch, Michel; Ghasemiesfe, Ahmadreza; Oldham, Justin M.

doi:10.1513/annalsats.202112-1377rl

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…Compared with CT scan, the sensitivity of chest radiography for ILD is 63% and specificity is 93% . Serologic testing for autoantibodies (including antinuclear antibody, an extended myositis panel, antineutrophil cytoplasmic antibodies, and rheumatoid factor or anticyclic citrullinated peptide antibodies) and serum-specific IgG antibodies (precipitins) can suggest CTD or hypersensitivity pneumonitis as potential diagnoses.…”

Section: Assessment and Diagnosismentioning

confidence: 99%

Interstitial Lung Disease

Maher

2024

JAMA

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ImportanceInterstitial lung disease (ILD) consists of a group of pulmonary disorders characterized by inflammation and/or fibrosis of the lung parenchyma associated with progressive dyspnea that frequently results in end-stage respiratory failure. In the US, ILD affects approximately 650 000 people and causes approximately 25 000 to 30 000 deaths per year.ObservationsThe most common forms of ILD are idiopathic pulmonary fibrosis (IPF), which accounts for approximately one-third of all cases of ILD, hypersensitivity pneumonitis, accounting for 15% of ILD cases, and connective tissue disease (CTD), accounting for 25% of ILD cases. ILD typically presents with dyspnea on exertion. Approximately 30% of patients with ILD report cough. Thoracic computed tomography is approximately 91% sensitive and 71% specific for diagnosing subtypes of ILDs such as IPF. Physiologic assessment provides important prognostic information. A 5% decline in forced vital capacity (FVC) over 12 months is associated with an approximately 2-fold increase in mortality compared with no change in FVC. Antifibrotic therapy with nintedanib or pirfenidone slows annual FVC decline by approximately 44% to 57% in individuals with IPF, scleroderma associated ILD, and in those with progressive pulmonary fibrosis of any cause. For connective tissue disease–associated ILD, immunomodulatory therapy, such as tocilizumab, rituximab, and mycophenolate mofetil, may slow decline or even improve FVC at 12-month follow-up. Structured exercise therapy reduces symptoms and improves 6-minute walk test distance in individuals with dyspnea. Oxygen reduces symptoms and improves quality of life in individuals with ILD who desaturate below 88% on a 6-minute walk test. Lung transplant may improve symptoms and resolve respiratory failure in patients with end-stage ILD. After lung transplant, patients with ILD have a median survival of 5.2 to 6.7 years compared with a median survival of less than 2 years in patients with advanced ILD who do not undergo lung transplant. Up to 85% of individuals with end-stage fibrotic ILD develop pulmonary hypertension. In these patients, treatment with inhaled treprostinil improves walking distance and respiratory symptoms.Conclusions and RelevanceInterstitial lung disease typically presents with dyspnea on exertion and can progress to respiratory failure. First-line therapy includes nintedanib or pirfenidone for IPF and mycophenolate mofetil for ILD due to connective tissue disease. Lung transplant should be considered for patients with advanced ILD. In patients with ILD, exercise training improves 6-minute walk test distance and quality of life.

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Section: Assessment and Diagnosismentioning

confidence: 99%

Interstitial Lung Disease

Maher

2024

JAMA

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“…Although ILD is reliably detected by high-resolution computed tomography (HRCT), a chest radiograph is still commonly used [ 4 ]. In contrast to HRCT, chest radiographs are available in almost all facilities and can be used quickly with minimal cost and negligible radiation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the interpretation of chest radiographs can be challenging, even for experienced radiologists, and is prone to low interobserver agreement [ 6 , 7 ]. According to a previous study, chest radiographs miss nearly 30% of cases when used for screening of fibrotic ILD [ 4 ]. Thus, considerable effort has been devoted to developing deep learning–based computer-aided detection systems for the evaluation of ILD on chest radiographs.…”

Section: Introductionmentioning

confidence: 99%

Pixel-Wise Interstitial Lung Disease Interval Change Analysis: A Quantitative Evaluation Method for Chest Radiographs Using Weakly Supervised Learning

Park,

Kim,

Woo

et al. 2024

Bioengineering

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Interstitial lung disease (ILD) is characterized by progressive pathological changes that require timely and accurate diagnosis. The early detection and progression assessment of ILD are important for effective management. This study introduces a novel quantitative evaluation method utilizing chest radiographs to analyze pixel-wise changes in ILD. Using a weakly supervised learning framework, the approach incorporates the contrastive unpaired translation model and a newly developed ILD extent scoring algorithm for more precise and objective quantification of disease changes than conventional visual assessments. The ILD extent score calculated through this method demonstrated a classification accuracy of 92.98% between ILD and normal classes. Additionally, using an ILD follow-up dataset for interval change analysis, this method assessed disease progression with an accuracy of 85.29%. These findings validate the reliability of the ILD extent score as a tool for ILD monitoring. The results of this study suggest that the proposed quantitative method may improve the monitoring and management of ILD.

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Idiopathische Lungenfibrose

Behr¹

2023

DGIM Innere Medizin

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Diagnostic Accuracy of Chest Radiography for Detecting Fibrotic Interstitial Lung Disease

Cited by 8 publications

References 14 publications

Interstitial Lung Disease

Interstitial Lung Disease

Pixel-Wise Interstitial Lung Disease Interval Change Analysis: A Quantitative Evaluation Method for Chest Radiographs Using Weakly Supervised Learning

Idiopathische Lungenfibrose

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