A new study recently published in the journal PLoS One reported data on a specific imaging tool to assess disease progression in patients with idiopathic pulmonary fibrosis (IPF). The study was conducted by an international research team and is entitled “Visual vs Fully Automatic Histogram-Based Assessment of Idiopathic Pulmonary Fibrosis (IPF) Progression Using Sequential Multidetector Computed Tomography (MDCT).”
IPF is a progressive fatal lung disease in which the alveoli and the lung tissue are damaged, becoming thick and scarred, leading to severe breathing difficulties and compromising oxygen transfer between the lungs and the bloodstream. The generation of this scar tissue is known as fibrosis. IPF is characterized by a shortness of breath that gradually worsens, with respiratory failure being the main cause of death associated with the disease. There is no cure for IPF and it is estimated that 128,000 individuals in the United States suffer from the disease, with approximately 48,000 new cases diagnosed every year. IPF has a poor prognosis and around two-thirds of the patients die within five years after being diagnosed.
It is crucial to assess IPF progression in patients to determine disease course and evaluate treatment efficacy. One potential method to assess disease progression is through a diagnostic imaging tool called multidetector computed tomography (MDCT). This system increases the speed of CT image acquisition and allows a high-resolution.
In this study, researchers conducted a retrospective analysis using chest MDCT data to assess the changes over time in 40 IPF patients (median age of 70 years) by two quantification methods: semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative analysis. All patients had undergone 2 MDCT with a median interval of 13 months.
The quantification of parenchymal abnormalities by MDCT over 1 year in IPF patients allowed the detection of an increase in the overall disease extent (median 5% per year), especially a major increment in fibrotic abnormalities. A relevant difference was found at MDCT in VSS and histogram analysis. The histogram-based approach showed a reasonable correlation with lung function tests, where lung density changes in the 40th percentile might reflect the overall extent of lung abnormalities, being potentially linked to a reversible acute inflammation, while changes in the 80th percentile might reflect the progression of irreversible fibrotic abnormalities.
The research team introduced a new, easier approach to estimate disease progression in IPF patients based on density changes of selected percentiles derived from the MDCT lung density histogram. Further studies with a larger number of patients should confirm these results.