Journal article
Assessing predictors of rheumatoid arthritis-associated interstitial lung disease using quantitative lung densitometry
Rheumatology (Oxford, England), Vol.61(7), pp.2792-2804
07/06/2022
DOI: 10.1093/rheumatology/keab828
PMCID: PMC9608004
PMID: 34747452
Abstract
Objective To assess predictors of subclinical RA-associated interstitial lung disease (RA-ILD) using quantitative lung densitometry (qLD). Methods RA patients underwent multi-detector row CT scanning at baseline and after an average of 39 months. Scans were analysed with qLD for the percentage of lung parenchyma with high attenuation areas (%HAA: the percentage of voxels of -600 to -250 Hounsfield units). Additionally, a pulmonary radiologist calculated an expert radiologist scoring (ERS) for RA-ILD features. Generalized linear models were used to identify indicators of baseline %HAA and predictors of %HAA change. Results Baseline %HAA was assessed in 193 RA patients and 106 had repeat qLD assessment. %HAA was correlated with ERS (Spearman's rho = 0.261; P < 0.001). Significant indicators of high baseline %HAA (>10% of lung parenchyma with high attenuation) included female sex, higher pack-years of smoking, higher BMI and anti-CCP >= 200 units, collectively contributing an area under the receiver operator curve of 0.88 (95% CI 0.81, 0.95). Predictors of %HAA increase, occurring in 49% with repeat qLD, included higher baseline %HAA, presence of mucin 5B (MUC5B) minor allele and absence of HLA-DRB1 shared epitope (area under the receiver operator curve = 0.69; 95% CI 0.58, 0.79). The association of the MUC5B minor allele with %HAA change was higher among men and those with higher cumulative smoking. Within the group with increased %HAA, anti-CCP level was significantly associated with a greater increase in %HAA. Conclusions %HAA, assessed with qLD, was linked to several known risk factors for RA-ILD and may represent a more quantitative method to identify RA-ILD and track progression than expert radiologist interpretation.
Details
- Title: Subtitle
- Assessing predictors of rheumatoid arthritis-associated interstitial lung disease using quantitative lung densitometry
- Creators
- Michail K. Alevizos - Columbia University Medical CenterSonye K. Danoff - Johns Hopkins UniversityDimitrios A. Pappas - Columbia University Medical CenterDavid J. Lederer - Columbia UniversityCheilonda Johnson - University of PennsylvaniaEric A. Hoffman - University of IowaElana J. Bernstein - Columbia University Medical CenterJoan M. Bathon - Columbia University Medical CenterJon T. Giles - Columbia University Medical Center
- Resource Type
- Journal article
- Publication Details
- Rheumatology (Oxford, England), Vol.61(7), pp.2792-2804
- Publisher
- Oxford Univ Press
- DOI
- 10.1093/rheumatology/keab828
- PMID
- 34747452
- PMCID
- PMC9608004
- ISSN
- 1462-0324
- eISSN
- 1462-0332
- Number of pages
- 13
- Grant note
- AR-050026-01 / National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH/NIAMS) (NIH) Rheumatology Research Foundation
- Language
- English
- Date published
- 07/06/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318703802771
Metrics
19 Record Views