DOI: 10.1101/493544Dec 13, 2018Paper

Longitudinal prediction of outcome in idiopathic pulmonary fibrosis using automated CT analysis

BioRxiv : the Preprint Server for Biology
Joseph JacobAthol U Wells


AIMS: To evaluate computer-derived (CALIPER) CT variables against FVC change as potential drug trials endpoints in IPF. METHODS: 71 Royal Brompton Hospital (discovery cohort) and 23 Mayo Clinic Rochester and 24 St Antonius Hospital Nieuwegein IPF patients (validation cohort) were analysed. Patients had two CTs performed 5-30 months apart, concurrent FVC measurements and were not exposed to antifibrotics (to avoid confounding of mortality relationships from antifibrotic use). Cox regression analyses (adjusted for patient age and gender) evaluated outcome for annualized FVC and CALIPER vessel-related structures (VRS) change and examined the added prognostic value of thresholded VRS changes beyond standard FVC change thresholds. RESULTS: Change in VRS was a stronger outcome predictor than FVC decline when examined as continuous variables, in discovery and validation cohorts. When FVC decline (greater or equal to 10%) and VRS thresholds were examined together, the majority of VRS change thresholds independently predicted outcome, with no decrease in model fit. When analysed as co-endpoints, a VRS threshold of greater or equal to 0.40 identified 30% more patients reaching an endpoint than a greater or equal to 10% FVC decline thresh...Continue Reading

Related Concepts

Blood Vessel
Clinical Trials
Drug Evaluation
Regression Analysis
X-Ray Computed Tomography
Cardiac CT

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