Prediction of pulmonary function decline in fibrotic interstitial lung abnormalties based on quantitative chest CT parameters

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Abstract

Background Interstitial lung abnormalities (ILA) is an imaging concept proposed, and fibrotic interstitial lung abnormalities have a higher risk of progression and death. Clinically, CT examination is more common and convenient compared with pulmonary function tests. The aim of this paper is to correlate quantitative CT airway parameters with pulmonary function parameters in patients with fibrotic ILA and to establish a prediction model for abnormal pulmonary function parameters in patients with fibrotic ILA. Methods In this paper, 95 cases with fibrotic ILA in CT images and 64 normal control cases were collected, and all of them completed pulmonary function tests within one week. The airway parameters of the CT images of the two groups of cases were measured using commercial software (Aview), and then the differences in airway parameters and lung function parameters between the two groups were regressed based on logistic multifactorial regression. Then analyse the correlation between airway parameters and lung function parameters among 95 patients with fibrotic ILA and the prediction model for abnormal lung function parameters in patients with fibrotic ILA was determined. Results After logistic multifactorial regression, it was determined that FVC%pred and WT (bronchial wall thickness) were correlated with fibrotic ILA. Then, 95 patients with fibrotic ILA were divided into a group with normal FVC%pred (n=69) and a group with decreased FVC%pred (n=26) at the 80% cut-off, and it was determined after logistic multifactorial regression that the correlation between age (OR: 1.11,95% CI: 1.02-1.21), sex (OR: 4.16,95% CI: 1.27- 13.71), LA 6 (the luminal area of the sixth generation brochi)(OR: 0.87,95%CI: 0.78-0.970), and WA(airway wall area)(OR: 1.12,95%CI: 1.02-1.24) were effective predictors of FVC%pred decline in patients with fibrotic ILA, and the AUC of the prediction model built from the above four parameters was 0.8428. Conclusion WT is a quantitative CT biomarker and FVC%pred is a valid lung function parameter in fibrotic ILA patients. Age, gender, LA 6 , and WA are effective predictors of FVC%pred decline in fibrotic ILA patients, and the combined model has good predictive value.

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