TY - JOUR
T1 - Lung vascular changes as biomarkers of severity in systemic sclerosis-associated interstitial lung disease
AU - Bruni, Cosimo
AU - Occhipinti, Mariaelena
AU - Pienn, Michael
AU - Camiciottoli, Gianna
AU - Bartolucci, Maurizio
AU - Bosello, Silvia Laura
AU - Payer, Christian
AU - Bálint, Zoltán
AU - Larici, Anna Rita
AU - Tottoli, Alessandra
AU - Tofani, Lorenzo
AU - De Lorenzis, Enrico
AU - Lepri, Gemma
AU - Bellando-Randone, Silvia
AU - Spinella, Amelia
AU - Giuggioli, Dilia
AU - Masini, Francesco
AU - Cuomo, Giovanna
AU - Lavorini, Federico
AU - Colagrande, Stefano
AU - Olschewski, Horst
AU - Matucci-Cerinic, Marco
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - OBJECTIVES: It has recently become possible to assess lung vascular and parenchymal changes quantitatively in thoracic CT images using automated software tools. We investigated the vessel parameters of patients with SSc, quantified by CT imaging, and correlated them with interstitial lung disease (ILD) features. METHODS: SSc patients undergoing standard of care pulmonary function testing and CT evaluation were retrospectively evaluated. CT images were analysed for ILD patterns and total pulmonary vascular volume (PVV) extents with Imbio lung texture analysis. Vascular analysis (volumes, numbers and densities of vessels, separating arteries and veins) was performed with an in-house developed software. A threshold of 5% ILD extent was chosen to define the presence of ILD, and commonly used cut-offs of lung function were adopted. RESULTS: A total of 79 patients [52 women, 40 ILD, mean age 56.2 (s.d. 14.2) years, total ILD extent 9.5 (10.7)%, PVV/lung volume % 2.8%] were enrolled. Vascular parameters for total and separated PVV significantly correlated with functional parameters and ILD pattern extents. SSc-associated ILD (SSc-ILD) patients presented with an increased number and volume of arterial vessels, in particular those between 2 and 4 mm of diameter, and with a higher density of arteries and veins of <6 mm in diameter. Considering radiological and functional criteria concomitantly, as well as the descriptive trends from the longitudinal evaluations, the normalized PVVs, vessel numbers and densities increased progressively with the increase/worsening of ILD extent and functional impairment. CONCLUSION: In SSc patients CT vessel parameters increase in parallel with ILD extent and functional impairment, and may represent a biomarker of SSc-ILD severity.
AB - OBJECTIVES: It has recently become possible to assess lung vascular and parenchymal changes quantitatively in thoracic CT images using automated software tools. We investigated the vessel parameters of patients with SSc, quantified by CT imaging, and correlated them with interstitial lung disease (ILD) features. METHODS: SSc patients undergoing standard of care pulmonary function testing and CT evaluation were retrospectively evaluated. CT images were analysed for ILD patterns and total pulmonary vascular volume (PVV) extents with Imbio lung texture analysis. Vascular analysis (volumes, numbers and densities of vessels, separating arteries and veins) was performed with an in-house developed software. A threshold of 5% ILD extent was chosen to define the presence of ILD, and commonly used cut-offs of lung function were adopted. RESULTS: A total of 79 patients [52 women, 40 ILD, mean age 56.2 (s.d. 14.2) years, total ILD extent 9.5 (10.7)%, PVV/lung volume % 2.8%] were enrolled. Vascular parameters for total and separated PVV significantly correlated with functional parameters and ILD pattern extents. SSc-associated ILD (SSc-ILD) patients presented with an increased number and volume of arterial vessels, in particular those between 2 and 4 mm of diameter, and with a higher density of arteries and veins of <6 mm in diameter. Considering radiological and functional criteria concomitantly, as well as the descriptive trends from the longitudinal evaluations, the normalized PVVs, vessel numbers and densities increased progressively with the increase/worsening of ILD extent and functional impairment. CONCLUSION: In SSc patients CT vessel parameters increase in parallel with ILD extent and functional impairment, and may represent a biomarker of SSc-ILD severity.
KW - interstitial lung disease
KW - lung vessels
KW - systemic sclerosis
UR - http://www.scopus.com/inward/record.url?scp=85147317875&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/keac311
DO - 10.1093/rheumatology/keac311
M3 - Article
C2 - 35708639
AN - SCOPUS:85147317875
SN - 1462-0332
VL - 62
SP - 696
EP - 706
JO - Rheumatology
JF - Rheumatology
IS - 2
ER -