Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study
Abstract Background Fibrotic types of interstitial lung abnormalities seen on high-resolution computed tomography scans, characterised by traction bronchiolectasis/bronchiectasis with or without honeycombing, are predictors of progression and poor prognostic factors of interstitial lung abnormalitie...
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BMC
2025-01-01
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| Online Access: | https://doi.org/10.1186/s12890-025-03520-4 |
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| author | Kazuya Ichikado Hidenori Ichiyasu Kazuhiro Iyonaga Kodai Kawamura Yuko Yasuda Keisuke Anan Hiroko Okabayashi Kimitaka Akaike Noritaka Higashi Takeshi Johkoh Kiminori Fujimoto Tetsuo Saito Jun Morinaga Minoru Yoshida Katsuhiko Mitsuzaki Takuro Sakagami |
| author_facet | Kazuya Ichikado Hidenori Ichiyasu Kazuhiro Iyonaga Kodai Kawamura Yuko Yasuda Keisuke Anan Hiroko Okabayashi Kimitaka Akaike Noritaka Higashi Takeshi Johkoh Kiminori Fujimoto Tetsuo Saito Jun Morinaga Minoru Yoshida Katsuhiko Mitsuzaki Takuro Sakagami |
| author_sort | Kazuya Ichikado |
| collection | DOAJ |
| description | Abstract Background Fibrotic types of interstitial lung abnormalities seen on high-resolution computed tomography scans, characterised by traction bronchiolectasis/bronchiectasis with or without honeycombing, are predictors of progression and poor prognostic factors of interstitial lung abnormalities. There are no reports on the clinical characteristics of fibrotic interstitial lung abnormalities on high-resolution computed tomography scans. Therefore, we aimed to examine these clinical characteristics and clarify the predictive factors of fibrotic interstitial lung abnormalities on high-resolution computed tomography scans. Methods Clinical and paraclinical data of 164 patients enrolled in the initial year of a multicentre prospective observational study (Kumamoto interstitial lung abnormalities study in Japan) involving over 62,000 examinees during routine health examinations were analysed. Clinical laboratory evaluations are expressed as medians and interquartile ranges for each evaluation time point, and boxplots were created for graphical representation. The percentages of abnormal clinical laboratory results were compared between the groups using chi-square or Fisher’s exact tests. Univariate or multivariate logistic regression analyses were performed to analyse the relationship between fibrotic interstitial lung abnormalities and other clinical factors. Results Fibrotic interstitial lung abnormalities were observed on high-resolution computed tomography scans in 135 (82%) patients at the time of diagnosis. Multivariate analysis showed that older age (Odds ratio, 1.06; 95% confidence interval, 1.01–1.12; p = 0.021), auscultatory fine crackles (Odds ratio, 3.39; 95% confidence interval, 1.33–8.65; p < 0.01), and elevated serum surfactant protein-D (Odds ratio, 2.68; 95% confidence interval, 1.02–8.64; p = 0.045) were independent predictive factors of fibrotic interstitial lung abnormalities. The predicted area under the curve of the fibrotic interstitial lung abnormalities based on these three factors was 0.77 (95% confidence interval, 0.68–0.86). The proportion of undecided diagnoses in the fibrotic interstitial lung abnormalities group (14%) was significantly lower than that in the non-fibrotic interstitial lung abnormalities group (41%) (p = 0.0027). Conclusions Fine crackles on auscultation and elevated serum surfactant protein-D levels are predictors of fibrotic interstitial lung abnormalities in older patients with interstitial lung abnormalities. These findings may assist non-radiological physicians in referring patients to specialists for early intervention in progressive fibrotic interstitial lung diseases. Trial registration number/date UMIN000045149/2021.12.1. |
| format | Article |
| id | doaj-art-f929111d00ec41928333bd1e99216743 |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-f929111d00ec41928333bd1e992167432025-02-02T12:06:38ZengBMCBMC Pulmonary Medicine1471-24662025-01-0125111110.1186/s12890-025-03520-4Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational studyKazuya Ichikado0Hidenori Ichiyasu1Kazuhiro Iyonaga2Kodai Kawamura3Yuko Yasuda4Keisuke Anan5Hiroko Okabayashi6Kimitaka Akaike7Noritaka Higashi8Takeshi Johkoh9Kiminori Fujimoto10Tetsuo Saito11Jun Morinaga12Minoru Yoshida13Katsuhiko Mitsuzaki14Takuro Sakagami15Division of Respiratory Medicine, Saiseikai Kumamoto HospitalDepartment of Respiratory Medicine, Faculty of Life Sciences, Kumamoto UniversityDepartment of Respiratory Medicine, Kumamoto Red Cross HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDepartment of Respiratory Medicine, Faculty of Life Sciences, Kumamoto UniversityDepartment of Respiratory Medicine, Faculty of Life Sciences, Kumamoto UniversityJapanese Red Cross Kumamoto Health Care CenterDepartment of Radiology, Kansai Rosai HospitalDepartment of Radiology, Kurume University School of Medicine and Centre for Diagnostic Imaging, Kurume University HospitalDivision of Integrative Medical Oncology, Saiseikai Kumamoto HospitalDepartment of Clinical Investigation (Biostatistics), Kumamoto University HospitalJapanese Red Cross Kumamoto Health Care CenterCenter for Preventive MedicineDepartment of Respiratory Medicine, Faculty of Life Sciences, Kumamoto UniversityAbstract Background Fibrotic types of interstitial lung abnormalities seen on high-resolution computed tomography scans, characterised by traction bronchiolectasis/bronchiectasis with or without honeycombing, are predictors of progression and poor prognostic factors of interstitial lung abnormalities. There are no reports on the clinical characteristics of fibrotic interstitial lung abnormalities on high-resolution computed tomography scans. Therefore, we aimed to examine these clinical characteristics and clarify the predictive factors of fibrotic interstitial lung abnormalities on high-resolution computed tomography scans. Methods Clinical and paraclinical data of 164 patients enrolled in the initial year of a multicentre prospective observational study (Kumamoto interstitial lung abnormalities study in Japan) involving over 62,000 examinees during routine health examinations were analysed. Clinical laboratory evaluations are expressed as medians and interquartile ranges for each evaluation time point, and boxplots were created for graphical representation. The percentages of abnormal clinical laboratory results were compared between the groups using chi-square or Fisher’s exact tests. Univariate or multivariate logistic regression analyses were performed to analyse the relationship between fibrotic interstitial lung abnormalities and other clinical factors. Results Fibrotic interstitial lung abnormalities were observed on high-resolution computed tomography scans in 135 (82%) patients at the time of diagnosis. Multivariate analysis showed that older age (Odds ratio, 1.06; 95% confidence interval, 1.01–1.12; p = 0.021), auscultatory fine crackles (Odds ratio, 3.39; 95% confidence interval, 1.33–8.65; p < 0.01), and elevated serum surfactant protein-D (Odds ratio, 2.68; 95% confidence interval, 1.02–8.64; p = 0.045) were independent predictive factors of fibrotic interstitial lung abnormalities. The predicted area under the curve of the fibrotic interstitial lung abnormalities based on these three factors was 0.77 (95% confidence interval, 0.68–0.86). The proportion of undecided diagnoses in the fibrotic interstitial lung abnormalities group (14%) was significantly lower than that in the non-fibrotic interstitial lung abnormalities group (41%) (p = 0.0027). Conclusions Fine crackles on auscultation and elevated serum surfactant protein-D levels are predictors of fibrotic interstitial lung abnormalities in older patients with interstitial lung abnormalities. These findings may assist non-radiological physicians in referring patients to specialists for early intervention in progressive fibrotic interstitial lung diseases. Trial registration number/date UMIN000045149/2021.12.1.https://doi.org/10.1186/s12890-025-03520-4Interstitial lung abnormalityIdiopathic pulmonary fibrosisProgressive pulmonary fibrosisHigh-resolution CTFine cracklesMultidisciplinary discussion |
| spellingShingle | Kazuya Ichikado Hidenori Ichiyasu Kazuhiro Iyonaga Kodai Kawamura Yuko Yasuda Keisuke Anan Hiroko Okabayashi Kimitaka Akaike Noritaka Higashi Takeshi Johkoh Kiminori Fujimoto Tetsuo Saito Jun Morinaga Minoru Yoshida Katsuhiko Mitsuzaki Takuro Sakagami Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study BMC Pulmonary Medicine Interstitial lung abnormality Idiopathic pulmonary fibrosis Progressive pulmonary fibrosis High-resolution CT Fine crackles Multidisciplinary discussion |
| title | Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study |
| title_full | Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study |
| title_fullStr | Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study |
| title_full_unstemmed | Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study |
| title_short | Predictive factors of fibrotic interstitial lung abnormality on high-resolution computed tomography scans: a prospective observational study |
| title_sort | predictive factors of fibrotic interstitial lung abnormality on high resolution computed tomography scans a prospective observational study |
| topic | Interstitial lung abnormality Idiopathic pulmonary fibrosis Progressive pulmonary fibrosis High-resolution CT Fine crackles Multidisciplinary discussion |
| url | https://doi.org/10.1186/s12890-025-03520-4 |
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