Interstitial lung abnormalities

Silva, Mario; Milanese, Gianluca; Sverzellati, Nicola

doi:10.1097/mcp.0000000000000497

“…14 Although each scan was reported by a radiologist who 'called' the GGO as fine fibrosis and the overall pattern as probable or definite UIP, other causes such as pulmonary oedema, acute exacerbation and infection could have contributed to this CT finding. 40 Nevertheless, our study shows that greater neutrophil count was significantly associated with quantifiable increase in fibrosis on imaging of the lungs in IPF. Further studies will be required to validate this finding.…”

Section: Discussionmentioning

confidence: 54%

“…From the point of fibrosis scoring, the sum of GGO, reticulation and honeycombing was used as the TLF score 14. Although each scan was reported by a radiologist who ‘called’ the GGO as fine fibrosis and the overall pattern as probable or definite UIP, other causes such as pulmonary oedema, acute exacerbation and infection could have contributed to this CT finding 40…”

Section: Discussionmentioning

confidence: 99%

Neutrophil levels correlate with quantitative extent and progression of fibrosis in IPF: results of a single-centre cohort study

Achaiah,

Fraser,

Saunders

et al. 2023

BMJ Open Resp Res

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with poor prognosis. Clinical studies have demonstrated association between different blood leucocytes and mortality and forced vital capacity (FVC) decline. Here, we question which blood leucocyte levels are specifically associated with progression of fibrosis, measured by accumulation of fibrosis on CT scan using a standardised automated method.MethodsUsing the Computer-Aided Lung Informatics for Pathology Evaluation and Rating CT algorithm, we determined the correlation between different blood leucocytes (<4 months from CT) and total lung fibrosis (TLF) scores, pulmonary vessel volume (PVV), FVC% and transfer factor of lung for carbon monoxide% at baseline (n=171) and with progression of fibrosis (n=71), the latter using multivariate Cox regression.ResultsNeutrophils (but not monocyte or lymphocytes) correlated with extent of lung fibrosis (TLF/litre) (r=0.208, p=0.007), PVV (r=0.259, p=0.001), FVC% (r=−0.127, p=0.029) at baseline. For the 71 cases with repeat CT; median interval between CTs was 25.9 (16.8–39.9) months. Neutrophil but not monocyte levels are associated with increase in TLF/litre (HR 2.66, 95% CI 1.35 to 5.25, p=0.005).ConclusionOur study shows that neutrophil rather than monocyte levels correlated with quantifiable increase in fibrosis on imaging of the lungs in IPF, suggesting its relative greater contribution to progression of fibrosis in IPF.

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“…14 Although each scan was reported by a radiologist who ‘called’ the GGO as fine fibrosis and the overall pattern as probable or definite UIP, other causes such as pulmonary oedema, acute exacerbation and infection could have contributed to this CT finding. 40…”

Section: Discussionmentioning

confidence: 99%

Neutrophil levels correlate with quantitative extent and progression of fibrosis in IPF: results of a single-centre cohort study

Achaiah,

Fraser,

Saunders

et al. 2023

Preprint

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with poor prognosis. Clinical studies have demonstrated association between different blood leukocytes and mortality and FVC decline. Here we question which blood leukocyte levels are specifically associated with progression of fibrosis, measured by accumulation of fibrosis on CT scan using a standardised automated method.MethodsUsing the CALIPER (Computer-Aided Lung Informatics for Pathology Evaluation and Rating) CT algorithm, we determined the correlation between different blood leukocytes (<4 months from CT) and total lung fibrosis (TLF) scores, pulmonary vessel volume (PVV), FVC% and TLCO% at baseline (n=171) and with progression of fibrosis (n=71), the latter using multivariate Cox regression.ResultsNeutrophils (but not monocyte or lymphocytes) correlated with extent of lung fibrosis (TLF/litre) (r=0.208, p=0.007), PVV (r=0.259, p=0.001), FVC% (r=-0.127, p=0.029) at baseline. For the 71 cases with repeat CT; median interval between CTs was 25.9 (16.8-39.9) months. Neutrophil but not monocyte levels are associated with increase in TLF/litre [HR 2.66, 95%CI, 1.35-5.25, p=0.005].ConclusionOur study shows that neutrophil rather than monocyte levels correlated with quantifiable increase in fibrosis on imaging of the lungs in IPF, suggesting its relative greater contribution to progression of fibrosis in IPF.Key messagesWHAT IS ALREADY KNOWN ON THIS TOPICIdiopathic pulmonary fibrosis (IPF) is a progressive fibrotic condition. Recently, several human studies have implicated blood leukocyte levels (monocyte, neutrophil and lymphocyte) with FVC decline and mortality. However, direct association between leukocytes and progression of fibrosis using quantitative CT analysis has not been explored.WHAT THIS STUDY ADDSThis study explored the association between blood monocytes, neutrophils and lymphocytes against increase in fibrosis over time, measured using a quantitative CT algorithm, CALIPER. We show that levels of blood neutrophil and lymphocytes but not monocytes were associated with greater risk of progression of fibrosis.HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE AND/OR POLICYOur study shows that neutrophil rather than monocyte levels correlated with quantifiable increase in fibrosis on imaging of the lungs in IPF, suggesting its relative greater contribution to progression of fibrosis in IPF.

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“…Interstitial lung abnormalities (ILA) are interstitial changes visible on computed tomography (CT). These abnormalities include ground-glass opacities, centrilobular nodules, non-emphysematous cysts, reticular pattern, honeycombing and traction bronchiectasis affecting >5% of any lung zone [ 1 – 3 ]. ILA can be an early stage of fibrotic lung diseases such as idiopathic pulmonary fibrosis (IPF) or other pulmonary diseases [ 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…These are described as ground-glass opacities, centrilobular nodules, nonemphysematous cysts, reticular pattern, honeycombing, and traction bronchiectasis affecting more than five per cent of any lung zone. [1][2][3] Interstitial lung abnormalities can be an early stage of fibrotic lung diseases such as idiopathic pulmonary fibrosis (IPF) or other pulmonary diseases. 2,4 There are associations between ILA, in particular those with honeycombing and traction bronchiectasis, and increased mortality.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of interstitial lung abnormalities in middle-aged never-smokers

Pesonen,

Johansson,

Johnsson

et al. 2023

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BackgroundInterstitial lung abnormalities (ILA) are incidental findings on chest CT. These patterns can present an early stage of fibrotic lung disease. Our aim was to estimate the prevalence of ILA in the Swedish population, in particular in never smokers, and find out its association with demographics, comorbidities, and symptoms.MethodsParticipants were recruited to the Swedish CArdioPulmonary BioImage Study (SCAPIS), a population-based survey including men and women aged 50–64 years performed at six university hospitals in Sweden. CT scan, spirometry and questionnaires were performed. ILA were defined as cysts, ground glass opacities, reticular abnormality, bronchiectasis, and honeycombing.FindingsOut of 29 521 participants, 14 487 were never smokers and 14 380 were men. In the whole population, 2870 (9.7%) had ILA of which 134 (0.5%) were fibrotic. In never smokers, the prevalence was 7.9% of which 0.3% were fibrotic. In the whole population, age, smoking history, chronic bronchitis, cancer, coronary artery calcium score and high-sensitive C-reactive protein were associated with ILA. Both ILA and fibrotic ILA were associated with restrictive spirometric pattern and impaired diffusing capacity for carbon monoxide. However, individuals with ILA did not report more symptoms compared with individuals without ILA.InterpretationInterstitial lung abnormalities are common in a middle-age Swedish population including never smokers. They may be at risk of being underdiagnosed since they are not a target for screening.

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Interstitial lung abnormalities

Abstract: ILA are a (minor) finding on HRCT and they should be reported by radiologists for optimal management within the specific clinic-functional scenario. ILA encompass a number of semiological characteristics associated with either fibrotic or nonfibrotic disease.

Cited by 8 publications

References 50 publications

Neutrophil levels correlate with quantitative extent and progression of fibrosis in IPF: results of a single-centre cohort study

Neutrophil levels correlate with quantitative extent and progression of fibrosis in IPF: results of a single-centre cohort study

Neutrophil levels correlate with quantitative extent and progression of fibrosis in IPF: results of a single-centre cohort study

High prevalence of interstitial lung abnormalities in middle-aged never-smokers

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