한빛사논문
- 조회385
Sohee Park1, MD, Jooae Choe1, MD, PhD, Hye Jeon Hwang1, MD, PhD, Han Na Noh2, MD, Young Ju Jung2, MD, PhD, Jung-Bok Lee3, PhD, Kyung-Hyun Do1, MD, PhD, Eun Jin Chae1, MD, PhD, Joon Beom Seo1, MD, PhD
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
2Health Screening and Promotion Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
3Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
*Corresponding author: Jooae Choe, MD, PhD
Abstract
Rationale: The optimal follow-up CT interval for detecting the progression of interstitial lung abnormality (ILA) is unknown.
Objectives: To identify optimal follow-up strategies and extent thresholds on CT relevant to outcomes.
Methods: This retrospective study included self-referred screening participants aged 50 years or older, including non-smokers, who had imaging findings relevant to ILA on chest CT scans. Consecutive CT scans were evaluated to determine the dates of the initial CT showing ILA and the CT showing progression. Deep learning-based ILA quantification was performed. Cox regression was used to identify risk factors for the time to ILA progression and progression to usual interstitial pneumonia (UIP).
Results: Of the 305 participants with a median follow-up of 11.3 years (interquartile range, 8.4-14.3), 239 (78.4%) had ILA on at least one CT scan. In participants with serial follow-up CTs, ILA progression was observed in 80.5% (161/200) and progression to UIP was observed in 17.3% (31/179), with median times to progression of 3.2 years (95% CI, 3.0-3.4) and 11.8 years (10.8-13.0), respectively. The extent of fibrosis on CT was an independent risk factor for ILA progression (hazard ratio, 1.12 [95% CI: 1.02-1.23]) and progression to UIP (hazard ratio, 1.39 [95% CI: 1.07-1.80]). Risk groups based on honeycombing and extent of fibrosis (1% in the whole lung or 5% per lung zone) showed significant differences in 10-year overall survival (P = .02).
Conclusions: For individuals with initially detected ILA, follow-up CT at 3-year intervals may be appropriate to monitor radiologic progression; however, those at high risk of adverse outcomes based on quantified extent of fibrotic ILA and presence of honeycombing may benefit from shortening the interval for follow-up scans.
논문정보
- Research article
- 2023년 08월 (BRIC 등록일 2023-09-07)
- 국내 연구진
- 의약학 > 응용의학
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