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| Content Provider | frontiers |
|---|---|
| Author | Venerito, Vincenzo Manfredi, Andreina Lopalco, Giuseppe Lavista, Marlea Cassone, Giulia Scardapane, Arnaldo Sebastiani, Marco Iannone, Florenzo |
| Abstract | Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In Oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on High-Resolution Computed Tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients. Methods: HRCTs of RA patients from January 2012 to March 2022 were analysed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in 3D Slicer, automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables. Results: We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (Interquartile Range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation (HR 9.35, 95% CI 1.56–55.86) as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05 - 0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18–0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82–2.83) was also retained as a confounder. Conclusions Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease. |
| ISSN | 2296858X |
| DOI | 10.3389/fmed.2022.1069486 |
| Volume Number | 9 |
| Journal | Frontiers in Medicine |
| Language | English |
| Publisher Date | 2023-01-09 |
| Access Restriction | Open |
| Subject Keyword | Rheumatoid arthritis-associated interstitial lung disease LASSO High-resolution computed tomography Biomarker Radiomics |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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