دورية أكاديمية
أعرض في EDS

Pleuroparenchymal fibroelastosis in idiopathic pulmonary fibrosis: Survival analysis using visual and computer-based computed tomography assessment.

التفاصيل البيبلوغرافية
العنوان: Pleuroparenchymal fibroelastosis in idiopathic pulmonary fibrosis: Survival analysis using visual and computer-based computed tomography assessment.
المؤلفون: Gudmundsson E; Centre for Medical Image Computing, UCL, 1st Floor, 90 High Holborn, London WC1V6LJ, United Kingdom., Zhao A; Centre for Medical Image Computing, UCL, 1st Floor, 90 High Holborn, London WC1V6LJ, United Kingdom., Mogulkoc N; Department of Respiratory Medicine, Ege University Hospital, Izmir, Turkey., Stewart I; National Heart & Lung Institute, Imperial College London, London, United Kingdom., Jones MG; NIHR Southampton Biomedical Research Centre and Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom., Van Moorsel CHM; Department of Pulmonology, Interstitial Lung Diseases Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands., Savas R; Department of Radiology, Ege University Hospital, Izmir, Turkey., Brereton CJ; NIHR Southampton Biomedical Research Centre and Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom., Van Es HW; Department of Radiology, St Antonius Hospital, Nieuwegein, the Netherlands., Unat O; Department of Respiratory Medicine, Ege University Hospital, Izmir, Turkey., Pontoppidan K; NIHR Southampton Biomedical Research Centre and Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom., Van Beek F; Department of Pulmonology, Interstitial Lung Diseases Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands., Veltkamp M; Department of Pulmonology, Interstitial Lung Diseases Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands.; Division of Heart and Lungs, University Medical Center, Utrecht, the Netherlands., Gholipour B; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom., Nair A; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom., Wells AU; Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College, London, United Kingdom., Janes SM; Lungs for Living Research Centre, UCL, London, United Kingdom., Alexander DC; Centre for Medical Image Computing, UCL, 1st Floor, 90 High Holborn, London WC1V6LJ, United Kingdom., Jacob J; Centre for Medical Image Computing, UCL, 1st Floor, 90 High Holborn, London WC1V6LJ, United Kingdom.; Lungs for Living Research Centre, UCL, London, United Kingdom.
المصدر: EClinicalMedicine [EClinicalMedicine] 2021 Jul 13; Vol. 38, pp. 101009. Date of Electronic Publication: 2021 Jul 13 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: The Lancet Country of Publication: England NLM ID: 101733727 Publication Model: eCollection Cited Medium: Internet ISSN: 2589-5370 (Electronic) Linking ISSN: 25895370 NLM ISO Abbreviation: EClinicalMedicine Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [London] : The Lancet, [2018]-
مستخلص: Background: Idiopathic pulmonary fibrosis (IPF) and pleuroparenchymal fibroelastosis (PPFE) are known to have poor outcomes but detailed examinations of prognostic significance of an association between these morphologic processes are lacking.
Methods: Retrospective observational study of independent derivation and validation cohorts of IPF populations. Upper-lobe PPFE extent was scored visually (vPPFE) as categories of absent, moderate, marked. Computerised upper-zone PPFE extent (cPPFE) was examined continuously and using a threshold of 2·5% pleural surface area. vPPFE and cPPFE were evaluated against 1-year FVC decline (estimated using mixed-effects models) and mortality. Multivariable models were adjusted for age, gender, smoking history, antifibrotic treatment and diffusion capacity for carbon monoxide.
Findings: PPFE prevalence was 49% (derivation cohort, n  = 142) and 72% (validation cohort, n  = 145). vPPFE marginally contributed 3-14% to variance in interstitial lung disease (ILD) severity across both cohorts.In multivariable models, marked vPPFE was independently associated with 1-year FVC decline (derivation: regression coefficient 18·3, 95 CI 8·47-28·2%; validation: 7·51, 1·85-13·2%) and mortality (derivation: hazard ratio [HR] 7·70, 95% CI 3·50-16·9; validation: HR 3·01, 1·33-6·81). Similarly, continuous and dichotomised cPPFE were associated with 1-year FVC decline and mortality (cPPFE ≥ 2·5% derivation: HR 5·26, 3·00-9·22; validation: HR 2·06, 1·28-3·31). Individuals with cPPFE ≥ 2·5% or marked vPPFE had the lowest median survival, the cPPFE threshold demonstrated greater discrimination of poor outcomes at two and three years than marked vPPFE.
Interpretation: PPFE quantification supports distinction of IPF patients with a worse outcome independent of established ILD severity measures. This has the potential to improve prognostic management and elucidate separate pathways of disease progression.
Funding: This research was funded in whole or in part by the Wellcome Trust [209,553/Z/17/Z] and the NIHR UCLH Biomedical Research Centre, UK.
Competing Interests: JJ reports fees from Boehringer Ingelheim, Roche, NHSX and GlaxoSmithKline unrelated to the submitted work. JJ was supported by Wellcome Trust Clinical Research Career Development Fellowship 209,553/Z/17/Z. SMJ reports fees from Astra-Zeneca, Bard1 Bioscience, Achilles Therapeutics, and Jansen unrelated to the submitted work. SMJ received assistance for travel to meetings from Astra Zeneca to American Thoracic Conference 2018 and from Takeda to World Conference Lung Cancer 2019 and is the Investigator Lead on grants from GRAIL Inc, GlaxoSmithKline plc and Owlstone. AUW personal fees and non-financial support from Boehringer Ingelheim, Bayer and Roche Pharmaceuticals; and personal fees from Blade, outside of the submitted work. EG, AZ, NM, IS, MGJ, CvM, RS, CJB, HWvE, OU, KP, FvB, MV, BG, AN, DA report no relevant conflicts of interest.
(© 2021 The Author(s).)
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فهرسة مساهمة: Keywords: Computed tomography; IPF; PPFE, Idiopathic pulmonary fibrosis; Pleuroparenchymal fibroelastosis; Quantitative analysis
تواريخ الأحداث: Date Created: 20210910 Latest Revision: 20220426
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8413236
DOI: 10.1016/j.eclinm.2021.101009
PMID: 34505028
قاعدة البيانات: MEDLINE
الوصف
تدمد:2589-5370
DOI:10.1016/j.eclinm.2021.101009