Mortality prediction in idiopathic pulmonary fibrosis: evaluation of computer-based CT analysis with conventional severity measures
Open accessAbstract
Computer-based computed tomography (CT) analysis can provide objective quantitation of disease in idiopathic pulmonary fibrosis (IPF). A computer algorithm, CALIPER, was compared with conventional CT and pulmonary function measures of disease severity for mortality prediction. CT and pulmonary function variables (forced expiratory volume in 1 s, forced vital capacity, diffusion capacity of the lung for carbon monoxide, transfer coefficient of the lung for carbon monoxide and composite physiologic index (CPI)) of 283 consecutive patients with a multidisciplinary diagnosis of IPF were evaluated against mortality. Visual and CALIPER CT features included total extent of interstitial lung disease, honeycombing, reticular pattern, ground glass opacities and emphysema. In addition, CALIPER scored pulmonary vessel volume (PVV) while traction bronchiectasis and consolidation were only scored visually. A combination of mortality predictors was compared with the Gender, Age, Physiology model. On univariate analyses, all visual and CALIPER-derived interstitial features and functional indices were predictive of mortality to a 0.01 level of significance. On multivariate analysis, visual CT parameters were discarded. Independent predictors of mortality were CPI (hazard ratio (95% CI) 1.05 (1.02–1.07), p<0.001) and two CALIPER parameters: PVV (1.23 (1.08–1.40), p=0.001) and honeycombing (1.18 (1.06–1.32), p=0.002). A three-group staging system derived from this model was powerfully predictive of mortality (2.23 (1.85–2.69), p<0.0001). CALIPER-derived parameters, in particular PVV, are more accurate prognostically than traditional visual CT scores. Quantitative tools such as CALIPER have the potential to improve staging systems in IPF.
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By measuring pulmonary VRSs, CALIPER software can outperform current gold standard measures of outcome in IPF by strongly predicting survival and likelihood of FVC decline, with effects enhanced over functional indices in patients with less extensive disease.
“By measuring pulmonary VRSs, the Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) software can outperform current gold standard measures of outcome in IPF, by strongly predicting survival and likelihood of forced vital capacity (FVC) decline with effects enhanced over functional indices in patients with less extensive disease (Jacob et al., 2017”
From Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies (2023) · cites this paper as Jacob et al., 2017
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“[11] Stratification for CT algorithm and GAP/CPI CPI estimated severity of ILD better than GAP.”
BackgroundSgalla, G., Larici, A. R., Sverzellati, N., Bartholmai, B., Walsh, S. L. F., Nikolic, D., Barney, A., Fletcher, S., Jones, M., Davies, D. D., et al. (2019) · European Respiratory Journal · doi:10.1183/13993003.02093-2018 · Cited by 15 · see citing works
Self-citation
- Authors
- Jacob, J., Bartholmai, B. J., Rajagopalan, S., Kokosi, M., Nair, A., Karwoski, R., Walsh, S. L. F., Wells, A. U., & Hansell, D. M.
- Affiliations
- Royal Brompton & Harefield NHS Foundation Trust (GB)
- Mayo Clinic (US)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2016-11-03
- Volume
- 49
- Issue
- 1
- Pages
- 1601011
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2548055772
- Cited by
- 309
- References
- 41
- Citations by year
- 2026: 25 · 2025: 37 · 2024: 36 · 2023: 39 · 2022: 34 · 2021: 30 · 2020: 31 · 2019: 33 · 2018: 21 · 2017: 22 · 2016: 1
- FWCI
- 22.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- idiopathic pulmonary fibrosis, mortality prediction, caliper, honeycombing, disease severity staging, composite physiologic index, lung function, interstitial lung disease, prognostic factors
- MeSH terms
- Aged, Algorithms, Female, Forced Expiratory Volume, United Kingdom, Humans, Lung, Male, Middle Aged, Prognosis, Retrospective Studies, Severity of Illness Index, Tomography, X-Ray Computed, Vital Capacity, Multivariate Analysis, Proportional Hazards Models, Kaplan-Meier Estimate, Idiopathic Pulmonary Fibrosis
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