Quantitative CT Enhances Early Detection of Progressive Pulmonary Fibrosis

Recent research published in The Annals of the American Thoracic Society highlights the role of quantitative CT in identifying radiological progression of progressive pulmonary fibrosis (PPF) ahead of conventional clinical evaluations. The study found lead times of up to 28 months, offering an opportunity for earlier diagnosis and intervention.

Conducted across three prominent US interstitial lung disease (ILD) centers—the University of Alabama at Birmingham, Weill Cornell Medicine, and the University of Chicago—this retrospective study included 509 patients with fibrotic ILD. The researchers utilized Brainomix e-Lung, an FDA-cleared and CE-marked AI-powered tool for quantitative CT analysis, to derive objective imaging metrics linked to disease progression.

The application of Brainomix e-Lung revealed radiological signs of progression, on average, 16 months prior to clinical diagnoses of PPF, with some cases identified as much as 28 months earlier at certain centers. Notably, the findings indicated that a significant portion of patients deemed clinically stable had radiological progression, underlining the potential for earlier therapeutic intervention.

Furthermore, the study established a correlation between specific quantitative CT measures and clinical outcomes. A high baseline weighted reticulovascular score (WRVS) was associated with a greater risk of future PPF, while a 1.5% change in total disease extent captured in serial CT scans was linked to increased mortality rates. These insights may help clinicians prioritize interventions sooner, potentially preserving lung function in a critical timeframe.

Professor Ayodeji Adegunsoye, a pulmonologist at the University of Chicago Medicine and lead author, emphasized that quantitative CT could help identify progression unnoticed in patients considered stable, thereby improving clinical decision-making.

Professor Peter George, a consultant pulmonologist at Royal Brompton Hospital and the study’s principal investigator, reinforced the significance of these findings, noting the capacity of quantitative CT to detect subtle radiological changes that might be missed through conventional assessments. The prospective implications could facilitate timely treatment interventions that benefit patient outcomes.

The research was supported by Boehringer Ingelheim, which aims to advance understanding and treatment of ILD. Their Senior Vice President, Martin Beck, highlighted the importance of early recognition of PPF progression, reinforcing the potential of quantitative CT in patient care.

Following this study, Brainomix and Boehringer Ingelheim plan to collaborate on PROGRESS-PPF, a prospective multicenter study aimed at further exploring the utility of AI-powered imaging in enhancing clinical assessments of PPF.