RPS 704 - Latest developments in interstitial lung disease (ILD) imaging

Author Block: R. H. Hayoz, N. Mansouri, C. Bongard, L. Righi, M. Obeid, C. Dromain, D. C. Rotzinger, C. Pozzessere; Lausanne/CH
Purpose: Interstitial lung abnormalities (ILA) have been associated with increased all-cause mortality. In oncologic patients, the relationship between pre-existing ILA and drug-induced pneumonitis (DIP) remains poorly understood. This study aimed to assess the prevalence of pre-existing ILA in patients who developed DIP, investigate their influence on DIP severity and radiological pattern, and evaluate ILA progression after DIP.
Methods or Background: We retrospectively analyzed CTs of cancer patients with confirmed DIP between 2020 and 2025. Two blinded readers assessed the presence and type of ILA at baseline CT, DIP pattern at the time of pneumonitis, and ILA progression on subsequent scans (≥30days post-DIP). Categorical variables were reported as percentages. Statistical analysis included percentages for categorical variables, Cohen’s Kappa for inter-reader ILA agreement, and Spearman’s rank correlation for ILA-DIP severity association.
Results or Findings: ILA were identified in 21/88 patients (24%; 6 females; median age 70 years, range 59–82). The predominant ILA pattern was subpleural non-fibrotic (81%, n=17). Inter-reader agreement was substantial (κ=0.655). ILA was mentioned in only one baseline radiological report. Organizing pneumonia was the most frequent DIP pattern for both non-ILA and ILA subgroups (50% and 62%, respectively). Grade ≥2 pneumonitis was recorded in 44 (50%) non-ILA and in 12 (57%) ILA patients. A weak, non-significant, positive correlation emerged between ILA and DIP severity (rho=0.174, p=0.126). Following DIP, ILA progression was detected in 11 patients (52%).
Conclusion: ILA are relatively common in oncologic patients but remain substantially underreported. Although their correlation with DIP severity was weak and not statistically significant, ILA progression occurred in over half of cases post-DIP, suggesting a potential impact on long-term pulmonary outcomes and patient management.
Limitations: retrospective design, single-center, relatively small ILA sample size, mixed cancer types and oncologic treatments
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Comité d’éthique de la recherche du canton de Vaud. CER-VD 2022-01536

Author Block: N. Landini¹, L. Jungblut², C. Strappa¹, C. Blüthgen², A. R. Larici¹, M. Matucci-Cerinic³, T. Frauenfelder², O. Distler², C. Bruni²; ¹Rome/IT, ²Zürich/CH, ³Milan/IT
Purpose: To identify and validate optimal thresholds of ILD extent quantified through Lung Texture Analysis (LTA) to detect the presence of ILD and extensive involvement in SSc patients.
Methods or Background: SSc patients visiting the Rheumatology Departments of University Hospital Zurich and the Careggi University Hospital Florence were identified for enrollment. Technically suitable images were analyzed through LTA™ (Imbio), quantifying the percentage of lung volume occupied by ILD. Two radiologists independently reviewed the CT scans to identify ILD and extensive disease, the latter defined as >20% of lung parenchyma involved, with disagreements resolved by consensus or third reviewer. Patients were randomly split 2:1 into derivation and validation cohorts. Receiver operating characteristic (ROC) curves with area under the curve (AUC) were computed to identify the optimal LTA ILD extent threshold for detecting ILD and extensive disease. Cox regression analysis was performed to determine the impact of ILD and extensive disease on mortality, adjusted for confounders.
Results or Findings: A total of 664 were eligible for the study. Visual analysis identified ILD in 313 (47%) cases, of whom 103 (33%) extensive ILD. In the derivation cohort (433 patients, 206 ILD, 38% extensive), ROC analysis identified the optimal ILD extent threshold for ILD detection at 1% (AUC 0.83), and at 7% for extensive ILD (AUC 0.84). In the validation cohort (231 patients, 104 ILD, 25% extensive), these thresholds achieved 78% sensitivity/71% specificity for ILD presence, and 81% sensitivity/70% specificity for extensive ILD. Over a median 5 years follow-up, 84 (13%) patients died. Both ILD presence and extensive ILD independently predicted mortality, with comparable results by visual and LTA™ assessments.
Conclusion: Our results lay the foundation for expanding the use of post-processing analysis in SSc-ILD towards automated diagnosis and stratification.
Limitations: Retrospective study.
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Ethic Committee Canton Zurich PB Nr 2018-0216
Comitato Etico Toscana Area Vasta Centro protocol 12300/oss and 15220/oss

Author Block: V. Uggenti¹, M. Di Battista¹, A. Della Rossa¹, L. Tavanti¹, A. De Liperi¹, B. Bartholmai², M. Mosca¹, E. Neri¹, C. Romei¹; ¹Pisa/IT, ²Rochester, MN/US
Purpose: This study aimed to assess, using CALIPER-derived quantitative parameters, the longitudinal course of interstitial lung disease secondary to systemic sclerosis (SSc-ILD), a complex condition characterized by alternating inflammatory exacerbations and progressive fibrotic changes.
Methods or Background: 50 SSc-ILD patients were included in the study (36 females; 14 males), with a mean age at baseline HRCT of 57.1 ± 13.0 years and a mean disease duration of 60.9 ± 81.5 months. Among them, 43 (86%) were receiving immunosuppressive therapy, and 7 (14%) were receiving antifibrotic treatment. All patients underwent at least two follow-up HRCT scans. All HRCTs were processed using CALIPER, which performs lung texture analysis, providing percentages of honeycombing (HC), reticulations (RET), ground glass (GG), vascular-related structures (VRS), and normal lung. ILD% was defined as the sum of GG%, RET%, and HC%.
Results or Findings: Pulmonary arterial hypertension (PAH) was associated with higher ILD (p=0.006) and VRS (p<0.001) values.
Among patients receiving immunosuppressive therapy, RET+HC showed a progressive increase over time. Conversely, GG displayed a distinct trend: in patients with baseline GG% <20%, follow-up oscillations suggested higher responsiveness to treatment; in contrast, patients with extensive baseline involvement (>20%) exhibited a progressive increase in GG.
ILD% was an independent predictor of pulmonary function: higher ILD% was associated with reduced FVC (β = –0.50, SE = 0.12, p<0.001) and DLCO (β = –0.77, SE = 0.11, p<0.001).
Conclusion: Higher ILD% and VRS% scores correlate with PAH.
The subanalysis of individual interstitial alterations suggests that GG% oscillations reflect responsiveness to immunosuppressive therapy.
The inverse correlation between ILD% and both FVC and DLCO supports the prognostic value of quantitative parameters.
Quantitative HRCT may support tailored therapeutic management in SSc-ILD.
Limitations: Single-center, retrospective design, with potential selection bias.
Imbalanced treatment groups.
Heterogeneous follow-up.
Funding for this study: None.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Interstiziopatia polmonare in corso di malattie autoimmuni sistemiche: correlazione del fenotipo polmonare con caratteristiche cliniche e sierologiche, uno studio osservazionale (AISILD); Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, Pisa; UO Reumatologia AOUP; Protocollo versione 2 del 06/04/2024.

Author Block: E. Temel, B. S. Akhan, H. ERTURK, M. e. Sahin, E. A. Tan Kaynar; Ankara/TR
Purpose: Interstitial lung diseases (ILDs) are characterized by inflammation and fibrosis leading to impaired lung function. High-resolution computed tomography (HRCT) allows quantitative assessment of lung structure, while pulmonary function tests (PFTs) evaluate function. The relationship between these measures over time remains underexplored. This study aims to investigate correlations between changes in CT-derived lung volumetric and densitometric parameters and alterations in PFT results in ILD patients.
Methods or Background: This retrospective cohort study included 142 ILD patients who underwent HRCT and PFT at two distinct time points. Lung volume and density metrics—total lung volume (TLV), total lung density (TLD), fibrotic parenchymal volume (FPV), and fibrotic percentage—were quantified. Changes (∆) were manually calculated and correlated with ∆FEV1, ∆FVC, and ∆FEV1/FVC ratio using Pearson’s correlation.
Results or Findings: ∆TLV correlated positively with ∆FEV1 (r = 0.192, p < 0.05) and ∆FVC (r = 0.228, p < 0.05). ∆TLD correlated negatively with ∆FEV1 (r = −0.249, p < 0.05). Both ∆FPV and fibrotic percentage inversely correlated with ∆FEV1 (r = −0.272 and −0.330, respectively, p < 0.05) and ∆FVC (r = −0.188 and −0.293, respectively, p < 0.05). Subgroup analysis showed significant correlations mainly in nonspecific interstitial pneumonia (NSIP) patients.
Conclusion: Changes in CT-derived volumetric and densitometric lung metrics correlate with pulmonary function changes in ILD, especially NSIP, supporting combined imaging and functional assessment for disease monitoring.
Limitations: This study has several limitations. First, its retrospective design may introduce selection bias and limits control over confounding variables. Second, the sample size, although sufficient for overall analysis, may be insufficient to detect subtle differences within some ILD subtypes, especially less common ones.Lastly, the study was conducted at a single center, which may limit the generalizability of the findings to broader populations.
Funding for this study: No funding was received for this study
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: Ethical approval of the study was obtained from the Ankara Atatürk Sanatorium Training and Research Hospital Clinical Research Ethics Committee (2024-BCEK/278, date: 14.05.2025).

Author Block: Y. Nagatani, H. Nakagawa, Y. Tsunoda, R. Uemura, K. Fukunaga, Y. Nakano, Y. Watanabe; Otsu/JP
Purpose: To investigate the relationship among dynamic concordance in upper lung subpleural normal-appearing lung parenchyma (SNAL) assessed on dynamic ventilation computed tomography (DVCT), the presence of subpleural irregular lines (SIL)reflecting pathological UIP pattern, clinical symptoms, and long-term prognosis in chronic interstitial pneumonia (IP).
Methods or Background: Fifty-four chronic IP patients underwent DVCT and pulmonary function tests (PFTs) in a single visit. Spherical volumes of interest (VOI) with a diameter of 10 mm were set at peak-inspiration in 8 subpleural SNAL, in ventral and dorsal mid sagittal plane. Automatic trucking functions obtained variable VOIs in 13-16 frame images (0.35 seconds/frame). Dynamic concordance of regional volume for SNAL with global lung volume (GLV) was assessed by cross-correlation coefficients in the volume (CCCv). The ratio of honeycomb volume to GLV (%HV) was measured on peak-inspiratory CT. In addition to the mean CCCv, PFT parameters and %HV were compared between survival and non-survival groups, between weak (modified MRC 0 or 1) and strong dyspnea groups (modified MRC 2 to 4), and between regions with SIL and those without using Mann-Whitney U test.
Results or Findings: CCCv for regions with SIL (0.61±0.50), was lower compared with those without (0.83±0.25)(p<0.0001). No difference in CCCv was found between weak and strong dyspnea groups. The mean CCCv (0.66±0.31) as well as %FVC, and % FEV1, in the non-survival group was lower than that in the survival group (0.81±0.15)(p=0.009). In addition, %HV in the non-survival groups (3.68±2.52) was higher compared with the survival group (2.17±2.15) (p=0.005).
Conclusion: DVCT demonstrated that dynamic discordance of the upper lung SNAL with global lung field was associated with subpleural irregular lines and long-term poor prognosis for chronic IP patients.
Limitations: The number of included patients was not so large.
Funding for this study: Grants-in-Aid for Scientific Research by Ministry of Education, Culture, Sports, Science and Technology of Japan (17K10361)
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: IRB of Shiga University of Medical Science

Author Block: M. Puseljic, A. J. Schlemmer, I. Vlasicek, A-K. Kaufmann-Bühler, F. Moazedi-Fürst, M. Fuchsjäger, E. Talakic; Graz/AT
Purpose: The position of interstitial pneumonia with autoimmune features (IPAF) within the interstitial lung disease (ILD) spectrum remains unclear, with limited data on the role of quantitative CT (QCT). This study aims to evaluate threshold-based QCT for distinguishing IPAF from other ILD subtypes and to assess the prognostic value of specific QCT features.
Methods or Background: In this retrospective single-center study, 227 patients (mean age, 63.6 ± 12.8 years) with CTD-ILD (n = 123), IPAF (n = 54), or IPF (n = 50) diagnosed between January 2005 and October 2024 were included. QCT assessed ground-glass opacity (GGO), consolidation, emphysema, affected lung, and the GGO-to-consolidation ratio. A general linear model was used for group comparison of QCT features; progression-free survival (PFS) was analysed with Kaplan–Meier and Cox regression to identify QCT-based risk factors for the whole study sample and for each subgroup.
Results or Findings: Lung consolidation was significantly higher in IPAF than in CTD-ILD (p = 0.046), while CTD-ILD showed higher GGO-to-consolidation ratios than IPAF (p < 0.001) and IPF (p = 0.009). IPAF had shorter PFS than CTD-ILD but longer than IPF. Higher GGO-to-consolidation ratios (HR, 0.87; 95% CI: 0.79–0.97; p = 0.011) and higher emphysema percentage (HR, 0.96; 95% CI: 0.93–0.99; p = 0.011) were associated with reduced risk of progression, whereas the usual interstitial pneumonia pattern was linked to higher risk (HR, 1.70; 95% CI: 1.07–2.71; p = 0.024). The GGO-to-consolidation ratio was associated with lower PFS only in the CTD-ILD group.
Conclusion: QCT demonstrated significant differences in imaging features and prognostic implications when comparing IPAF with other ILD subtypes.
Limitations: CT scans were performed on different scanners, and there was an imbalance between subgroup sample sizes.
Funding for this study: No fundings recieved.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Ethics Committee Medical University of Graz (36-202 ex 23/24)

Author Block: Y. Nagatani, H. Nakagawa, R. Uemura, Y. Tsunoda, K. Fukunaga, Y. Nakano, Y. Watanabe; Otsu/JP
Purpose: To investigate the association of dynamic concordance between global lung volume (GLV) and global bronchial volume (GBV) measured on dynamic ventilation computed tomography (DVCT) with prognosis
Methods or Background: Sixty-seven chronic interstitial pneumonia patients, including 22 idiopathic pulmonary fibrosis (IPF), underwent DVCT. GLV and GBV were measured in each of 13 to 17 frame images (0.35 seconds/frame), and their change ratio (GLVcr and GBVcr) were calculated. Cross-correlation coefficients between GLV and GBV (CCCv), and between GLVcr and GBVcr (CCCvcr) were assessed. Percentage of honeycomb volume to GLV (%HV) was measured as pulmonary fibrosis extent on peak-inspiratory CT. Mortality and the latest survival data were recorded. Following two analyses were performed in IPF, non-IPF as well as the total population: 1) CCCv, CCCvcr and %HV were compared between alive and non-alive groups. 2) Using cutoff values determined based on the area under the receiver operating characteristic curve, mortality difference for the 3 parameters were assessed by log-rank test under Kaplan-Meier curve.
Results or Findings: In addition to value difference between the 2 groups, patients with %HV of 2.05 or more had lower survival rates compared to those without (median survival time, 1756 vs 1933 days; p=0.002) for non-IPF as well as total. In contrast, CCCvcr for non-alive group (0.584±0.254) was lower than alive group (0.814±0.092) for IPF as well as total (p=0.008). Moreover, patients with CCCvcr of 0.795 or less had lower survival rates compared to those without (median survival time, 932 vs 1701 days; p=0.034) for IPF as well as non-IPF and total.
Conclusion: Respiratory discordance of GBVcr with GLVcr assessed on DVCT as well as %HV could be a useful indicator of prognosis especially for IPF.
Limitations: The number of included patients was not so large.
Funding for this study: Grants-in-Aid for Scientific Research by Ministry of Education, Culture, Sports, Science and Technology of Japan (17K10361)
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: IRB of Shiga University of Medical Science

Author Block: M. E. Diana¹, G. Pellegrino², D. Mohammad Reza Beigi¹, M. Orlandi³, C. Bruni⁴, V. Riccieri¹, M. Matucci-Cerinic², V. Panebianco¹, N. Landini¹; ¹Rome/IT, ²Milan/IT, ³Modena/IT, ⁴Florence/IT
Purpose: To compare the relationships of three CT Visual Scores (VSs) of lung alterations and two Lung Texture Analyses (LTAs) with pulmonary function tests in Systemic Sclerosis-Interstitial Lung Disease (SSc-ILD), identifying which method best reflects functional decline.
Methods or Background: Patients followed by two Rheumatology Units were evaluated. Chest CTs with Forced Vital Capacity (FVC%) and Lung Carbon Monoxide Diffusing Capacity (DLCO%) assessed within one month were included. Two radiologists performed three visual scores in consensus: Visual1 (involvement assessed at five levels), Visual2 (six levels), and Visual3 (six zones, whole lung evaluation). LTAs were performed with two software (Aview and IMBIO). A linear regression including clinical covariates (age, sex, smoking habits, antibody subset, pulmonary hypertension) was applied. The model fit was assessed using adjusted R2 (p<0.05). The agreement between the best VS and LTA was also evaluated using Bland–Altman analyses.
Results or Findings: 55 patients were included (44 women, median age 59 years). The median ILD extent ranged 17.0%-20% with VSs, and 6%-9.7% with LTAs. Linear regression with FVC% yielded R² values ranging from 0.267 to 0.371 for VSs, and from 0.223 to 0.478 for LTAs (p<0.01). Aview provided the best fit, followed by Visual3. Linear regression with DLCO% produced R² values ranging from 0.143 to 0.283 for VSs and from 0.223 to 0.230 for LTAs (p<0.05). Visual3 provided the best fit, followed by Aview. As ILD extent increased, the difference between Aview and Visual3 tended to increase (mean difference -13%, slope -0.213).
Conclusion: Aview and Visual3 assessments provided the best relationship with FVC% and DLCO%, respectively. The difference in ILD extent between the two methods may not be negligible at higher extents, where Aview tends to underestimate ILD compared to Visual3.
Limitations: Retrospective study, patients number
Funding for this study: None.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Rif. 7284 Prot. 0681/2023 Comitato Etico Territoriale Lazio Area 1
Careggi, Florence, 27299/2019, code 15220/oss
CESC Treviso-Belluno, 641/CECEAV

Author Block: Z. Chahbi, S. Wakrim; Agadir/MA
Purpose: Interstitial lung abnormalities (ILA) are incidental radiological findings involving at least 5% of the lung parenchyma in asymptomatic individuals. The COVID-19 pandemic has raised concerns about post-viral lung damage contributing to ILA and its progression to pulmonary fibrosis. This study aims to assess the prevalence and characteristics of ILA in a post-COVID-19 population and explore potential associations with fibrotic changes.
Methods or Background: A retrospective analysis was conducted on 343 chest CT scans of patients over 40 years old with no prior diagnosis of interstitial lung disease (ILD) from January 2023 to January 2024. ILAs were classified into three subtypes based on Fleischner Society criteria: non-subpleural ILA, subpleural non-fibrosing ILA, and subpleural fibrosing ILA. CT scans were evaluated for key radiological features, including ground-glass opacities, reticulations, septal thickening, traction bronchiectasis, cysts, honeycombing, and architectural distortion. Statistical analysis was performed using IBM SPSS Statistics.
Results or Findings: The overall prevalence of ILA was 18%, with subpleural fibrosing ILA and subpleural non-fibrosing ILA each accounting for 8%, and non-subpleural ILA for 2%. A female predominance (58%) was observed, with a mean patient age of 59 years. Compared to pre-pandemic literature, which reported a 7% prevalence in general populations, our findings suggest an increase in ILA prevalence, particularly in fibrosing subtypes.
Conclusion: The study highlights a potentially higher detection rate of fibrosing ILAs in the post-COVID era, raising concerns about long-term lung remodeling and progression to ILD. The increased proportion of fibrosing ILA warrants further longitudinal research to assess its evolution and the need for modified follow-up strategies. Radiologists play a crucial role in early identification and risk stratification to prevent irreversible lung damage.
Limitations: None
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Approved

Author Block: S. Piao, B. LI, L. Zhao, R. Zhao, J. Wang, R. Xiao, Y. Ming, W. Song; Beijing/CN
Purpose: To characterize lobar and segmental airway volume differences between systemic lupus erythematosus (SLE) patients with interstitial lung disease (ILD) and those without ILD (non-ILD) using a deep learning-based approach on non-contrast chest high-resolution CT (HRCT).
Methods or Background: A retrospective analysis was conducted on 106 SLE patients (27 SLE-ILD, 79 SLE-non-ILD) who underwent HRCT. A customized deep learning framework based on the U-Net architecture was developed to automatically segment airway structures at the lobar and segmental levels via HRCT. Volumetric measurements of lung lobes and segments derived from the segmentations were statistically compared between the two groups using two-sample t-tests (significance threshold: p < 0.05).
Results or Findings: At lobar level, significant airway volume enlargement in SLE-ILD patients was observed in the right upper lobe (p=0.009) and left upper lobe (p=0.039) compared to SLE-non-ILD. At the segmental level, significant differences were found in segments including R1 (p=0.016), R3 (p<0.001), and L3 (p=0.038), with the most marked changes in the upper lung zones, while lower zones showed non-significant trends.
Conclusion: Our study demonstrates that an automated deep learning-based approach can effectively quantify airway volumes on HRCT scans and reveal significant, region-specific airway dilation in patients with SLE-ILD compared to those without ILD. The pattern of involvement, predominantly affecting the upper lobes and specific segments, highlights a distinct topographic phenotype of SLE-ILD and implicates airway structural alterations as a potential biomarker for disease presence. This AI-powered quantitative imaging biomarker holds promise for enhancing the early detection and monitoring of ILD in the SLE population, ultimately contributing to more personalized patient management.
Limitations: It was a retrospective and single-center study, and the generalizability of our findings needs validation in larger, multi-ethnic and longitudinal cohorts.
Funding for this study: Peking Union Medical College Hospital Research Funding for Postdoc (kyfyjj202412); China Postdoctoral Science Foundation(2025M772188 )
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Institutional Review Board of Peking Union Medical College Hospital .

Author Block: J. Wang, R. Zhao, R. Xiao, S. Piao, R. Zhao, Y. Ming, X. Sui, W. Song; Beijing/CN
Purpose: To characterize longitudinal chest CT changes in patients with antisynthetase antibody syndrome–associated interstitial lung disease (ASS-ILD), evaluate their relationship with pulmonary function, and assess the prognostic value of quantitative CT parameters.
Methods or Background: This retrospective study included 60 newly diagnosed ASS-ILD patients (April 2014–December 2022) with positive anti-synthetase antibodies and ≥2 chest CT scans. Clinical, serological, pulmonary function test, and CT data were analyzed. CT abnormalities and patterns were assessed visually and quantified using semi-quantitative CT scores and automated quantitative CT software. Patients were stratified by clinical outcomes (regression, stability, deterioration) and baseline disease severity.
Results or Findings: Median follow-up was 25 months with 404 CT scans reviewed. Ground-glass opacities, linear opacities, and consolidations predominated at baseline. Over time, traction bronchiectasis significantly progressed (p<0.001), while consolidation, pleural thickening, and OP patterns declined. Fibrotic patterns increased, particularly in anti-PL-12 (100%), anti-Jo-1 (77.4%), and anti-EJ (77.8%) subgroups. Baseline traction bronchiectasis was more frequent in stability/deterioration groups, whereas OP pattern and consolidation favored regression. CT scores and quantitative CT parameters (MLD, HAV%) correlated strongly with FVC%, FEV₁%, TLC, and VC, and moderately with DLco%. The more advanced group exhibited higher CT scores, MLD values and HAV% and lower LAV%.
Conclusion: Longitudinal CT assessment in ASS-ILD reveals progression to fibrotic patterns, with strong correlations between quantitative CT parameters and pulmonary function test. Both CT scores and quantitative CT parameters provide prognostic insights and may guide individualized management.
Limitations: First, it was a single-center, retrospective study with relatively small subgroup sizes, which may limit the generalizability of our findings. Second, the follow-up period was relatively short, preventing evaluation of the association between imaging scores and patient survival outcomes.
Funding for this study: National Natural Science Foundation of China (No. 82173623)
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: S. Piao, B. LI, L. Zhao, Y. Ming, R. Zhao, J. Wang, R. Xiao, R. Zhao, W. Song; Beijing/CN
Purpose: To investigate the structural differences in pulmonary arteries and veins at lobar and segmental levels between systemic lupus erythematosus (SLE) patients with interstitial lung disease (ILD) and those without ILD (non-ILD) using deep learning-driven chest high-resolution CT (HRCT) analysis.
Methods or Background: A retrospective cohort of 106 SLE patients (27 SLE-ILD, 79 SLE-non-ILD) underwent chest HRCT. A deep learning algorithm (U-Net
architecture) was trained to segment pulmonary arteries and veins at lobar and segmental levels via non-contrast chest HRCT, and vascular volumes were calculated. Group-wise comparisons were performed using two sample t-test, with significance set at p<0.05.
Results or Findings: Significant differences in pulmonary vasculature were observed between SLE-ILD and SLE-non-ILD groups. At lobar Level, SLE-ILD patients demonstrated significantly larger arterial volumes in the right upper lobe (p<0.001) and left upper lobe (p=0.002) compared to SLE-non-ILD. SLE-ILD patients exhibited increased venous volumes in the right upper lobe (p=0.001) and reduced volumes in the left lower lobe (p=0.030). At segmental Level, SLE-ILD patients showed higher arterial volumes in segments R1 (p=0.010), R3 ( p<0.001), R7 (p=0.010), and L3 (p=0.001), but lower volumes in L9 (p=0.005) and L10 (p=0.019). SLE-ILD patients had elevated venous volumes in segments R1 (p=0.001), R2 (p=0.003), R3 (p=0.002), L1-2 (p=0.017), and L3 ( p=0.019), but reduced volumes in L9 (p=0.003) and L10 (p=0.004).
Conclusion: Our study demonstrates a characteristic pattern of upper lobe arterial and venous enlargement coupled with lower lobe venous reduction in SLE-ILD, suggesting a complex interplay between SLE-associated vasculopathy and interstitial changes. AI-derived vascular metrics hold promise for improving the early diagnosis, risk stratification, and monitoring of SLE-ILD.
Limitations: It was a retrospective and single-center study, and the generalizability of our findings needs validation in larger, multi-ethnic and longitudinal cohorts.
Funding for this study: Peking Union Medical College Hospital Research Funding for Postdoc (kyfyjj202412); China Postdoctoral Science Foundation(2025M772188 )
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Institutional Review Board of Peking Union Medical College Hospital .