{
  "abstract": "Introduction Radiomic analysis of chest high-resolution computed tomography (HRCT) has emerged as a novel tool for the objective assessment of systemic sclerosis-associated interstitial lung disease (SSc-ILD). An increase in the pulmonary vessel volume (PVV) quantified on HRCT has been linked to SSc-ILD severity and linked to mortality in idiopathic pulmonary fibrosis (IPF) and rheumatoid arthritis (RA)-associated ILD. Here, we evaluated the value of CT-derived radiomic features as predictors of ILD progression and mortality in SSc-ILD.Material and Methods We included SSc patients from the Zurich cohort with ILD confirmed on HRCT and follow-up information.HRCT scans underwent lung texture analysis using the LTA™ software (Imbio). The extent of PVV and lung pathologies (hyperlucency, ground-glass, reticular, honeycombing) were quantified for whole lungs and by lung zones (upper, middle, lower).Progression analysis focused on patients with repeated pulmonary function tests within 12±3 months. Progression was defined as an absolute FVC decline >= 5% or absolute DLCO decline >=10%. Radiomics predictors of progression were assessed with Generalized Estimating Equations (GEE), adjusted for confounders (age, sex, disease duration, NYHA class >II, baseline DLCO and FVC, diffuse skin involvement).Cox proportional hazards models were used to assess radiomic predictors of mortality, observing patients from the first ILD-positive CT until last contact (death or alive status), adjusted for the SCOpE score.Results Among 261 yearly follow-up visits from 160 SSc-ILD patients, 40% showed at least one episode of ILD progression, with a total of 99 (37.7%) occurrences of functional decline. Radiomic features were comparable among progressors and non-progressors. Among all radiomic features, the extent of honeycombing in the whole lung was identified as independent predictor of functional decline [adj OR 1.539, 95% CI 1.174-2.017].Over 42 (IQR 27-110) months follow-up, 65/267 (24%) SSc-ILD patients died. Patients who died were older, with shorter disease duration, more frequently smokers ever, with increased inflammatory markers and more severe functional impairment. At baseline, SSc-ILD patients who died also showed greater extent of both PVV% and parenchymal alterations across all lung zones. PVV% was an independent predictor of mortality [adj HR 1.217, 95% CI 1.094–1.354], particularly in the upper zones [adj HR 1.280, 95% CI 1.118–1.466].Conclusions The extent of honeycombing predicts ILD progression, while PVV% is a predictor of mortality, consistently with the data in IPF and RA-ILD, supporting the role of radiomic LTA analysis in the risk stratification and prognosis of SSc-ILD patients.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome, Italy",
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Maria Iacovantuono"
    },
    {
      "affiliations": [
        "Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Policlinico Umberto I, Rome, Italy"
      ],
      "name": "Nicholas Landini"
    },
    {
      "affiliations": [
        "Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland"
      ],
      "name": "Lisa Jungblut"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Florian Käs"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Rucsandra Dobrota"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Sinziana Muraru"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Muriel Elhai"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Carmen-Marina Mihai"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Mike Oliver Becker"
    },
    {
      "affiliations": [
        "Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome, Italy"
      ],
      "name": "Maria Sole Chimenti"
    },
    {
      "affiliations": [
        "Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland"
      ],
      "name": "Thomas Frauenfelder"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland",
        "Department of Rheumatology, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "Anna-Maria Hoffman-Vold"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Oliver Distler"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Cosimo Bruni"
    }
  ],
  "title": "P.105 Quantitative computed tomography radiomic features as predictors of progression and mortality in systemic sclerosis-associated interstitial lung disease",
  "uid": "7650df30-ac30-5e79-bbcb-25158da1149a"
}