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Imaging Patterns Are Associated with Interstitial Lung Abnormality Progression and Mortality.

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Authors
Putman, Rachel K
Gudmundsson, Gunnar
Axelsson, Gisli Thor
Hida, Tomoyuki
Honda, Osamu
Araki, Tetsuro
Yanagawa, Masahiro
Nishino, Mizuki
Miller, Ezra R
Eiriksdottir, Gudny
Gudmundsson, Elías F
Tomiyama, Noriyuki
Honda, Hiroshi
Rosas, Ivan O
Washko, George R
Cho, Michael H
Schwartz, David A
Gudnason, Vilmundur
Hatabu, Hiroto
Hunninghake, Gary M
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Issue Date
2019-07-15

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Citation
Imaging Patterns Are Associated with Interstitial Lung Abnormality Progression and Mortality. 2019, 200(2):175-183 Am J Respir Crit Care Med
Abstract
Rationale: Interstitial lung abnormalities (ILA) are radiologic abnormalities on chest computed tomography scans that have been associated with an early or mild form of pulmonary fibrosis. Although ILA have been associated with radiologic progression, it is not known if specific imaging patterns are associated with progression or risk of mortality. Objectives: To determine the role of imaging patterns on the risk of death and ILA progression. Methods: ILA (and imaging pattern) were assessed in 5,320 participants from the AGES-Reykjavik Study, and ILA progression was assessed in 3,167 participants. Multivariable logistic regression was used to assess factors associated with ILA progression, and Cox proportional hazards models were used to assess time to mortality. Measurements and Main Results: Over 5 years, 327 (10%) had ILA on at least one computed tomography, and 1,435 (45%) did not have ILA on either computed tomography. Of those with ILA, 238 (73%) had imaging progression, whereas 89 (27%) had stable to improved imaging; increasing age and copies of MUC5B genotype were associated with imaging progression. The definite fibrosis pattern was associated with the highest risk of progression (odds ratio, 8.4; 95% confidence interval, 2.7-25; P = 0.0003). Specific imaging patterns were also associated with an increased risk of death. After adjustment, both a probable usual interstitial pneumonia and usual interstitial pneumonia pattern were associated with an increased risk of death when compared with those indeterminate for usual interstitial pneumonia (hazard ratio, 1.7; 95% confidence interval, 1.2-2.4; P = 0.001; hazard ratio, 3.9; 95% confidence interval, 2.3-6.8;P < 0.0001), respectively. Conclusions: In those with ILA, imaging patterns can be used to help predict who is at the greatest risk of progression and early death.
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Additional Links
https://www.atsjournals.org/doi/10.1164/rccm.201809-1652OC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635786/
ae974a485f413a2113503eed53cd6c53
10.1164/rccm.201809-1652OC
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English Journal Articles (Peer Reviewed)

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