Association of computed tomography densitometry with disease progression and spatial heterogeneity in rheumatoid arthritis-associated interstitial lung disease

IF 2.8 4区医学 Q3 IMMUNOLOGY

Immunology letters Pub Date : 2026-08-01 Epub Date: 2026-02-28 DOI:10.1016/j.imlet.2026.107157

Zhinan Guo , Yu Zhang , Guanheng Li , Nie Han , Xingting Jiang , Jiawei Ma , Yayi Qin , Diru Zhu , Xiaoli Gu , Lin Jin

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引用次数: 0

Abstract

Objectives

This study aimed to assess the efficacy of quantitative computed tomography (qCT) in distinguishing rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and monitoring its progression.

Methods

HRCT images of 138 RA-ILD patients (GAP_I, n = 90; GAP_II+III, n = 48) and 47 RA controls were retrospectively analyzed. The normal lung attenuation areas (NL%), the percentage of low attenuation areas (LAA%), and the percentage of high-attenuation areas (HAA%) were measured for each lung lobe. Correlations between qCT indices and pulmonary function tests were evaluated using Spearman’s rank correlation. ROC curves tested the discriminative performance of qCT indices. Multivariable logistic regression assessed associations between qCT indices and RA-ILD.

Results

The NL% decreased, while the LAA% and HAA% increased in the early and moderate-to-advanced stages of ILD, respectively (p < 0.05). Multivariate regression identified HAA% as an independent risk factor for ILD staging (OR: 1.737, 95% CI: 1.182–2.551, p = 0.005). When combining NL%, LAA%, and HAA%, the AUCs for early diagnosis and progression monitoring were 0.760 and 0.773, respectively (p < 0.05). RA-ILD exhibited spatial heterogeneity, with the lower lobes being primarily affected.

Conclusions

Quantitative parameters can effectively differentiate early-stage RA-ILD and monitor its progression. LAA% is significantly correlated with early diagnosis, whereas HAA% demonstrates higher specificity in later stages. Quantitative lung densitometry may prove to be a valuable tool for clinical decision-making.

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类风湿关节炎相关间质性肺疾病的计算机断层密度测量与疾病进展和空间异质性的关系

目的：本研究旨在评估定量计算机断层扫描（qCT）在鉴别类风湿关节炎相关间质性肺疾病（RA-ILD）和监测其进展方面的疗效。方法：回顾性分析138例RA- ild患者（GAPI, n=90; GAPII+III, n=48）和47例RA对照的HRCT图像。测定各肺叶肺正常衰减面积（NL%）、低衰减面积百分比（LAA%）、高衰减面积百分比（HAA%）。采用Spearman秩相关评价qCT指标与肺功能检查的相关性。ROC曲线检验了qCT指标的判别性能。多变量logistic回归评估了qCT指标与RA-ILD之间的关系。结果：在ILD的早期和中晚期，NL%降低，LAA%和HAA%升高(p)。结论：定量参数可有效鉴别早期RA-ILD并监测其进展。LAA%与早期诊断显著相关，而HAA%在晚期表现出更高的特异性。定量肺密度测量可能被证明是临床决策的一个有价值的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Immunology letters 医学-免疫学

CiteScore

7.60

自引率

0.00%

发文量

审稿时长

44 days

期刊介绍： Immunology Letters provides a vehicle for the speedy publication of experimental papers, (mini)Reviews and Letters to the Editor addressing all aspects of molecular and cellular immunology. The essential criteria for publication will be clarity, experimental soundness and novelty. Results contradictory to current accepted thinking or ideas divergent from actual dogmas will be considered for publication provided that they are based on solid experimental findings. Preference will be given to papers of immediate importance to other investigators, either by their experimental data, new ideas or new methodology. Scientific correspondence to the Editor-in-Chief related to the published papers may also be accepted provided that they are short and scientifically relevant to the papers mentioned, in order to provide a continuing forum for discussion.