title: Quantitative texture-based assessment of one-year changes in fibrotic reticular patterns on HRCT in scleroderma lung disease treated with oral cyclophosphamide.
abstract: OBJECTIVE
  The Scleroderma Lung Study showed the efficacy of cyclophosphamide in modestly improving the forced vital capacity (FVC) compared with placebo over 1 year. Using changes in texture-based scores that quantify lung fibrosis as the percentage involvement of reticulation patterns, the effectiveness of cyclophosphamide was re-assessed by examining its impact on quantitative lung fibrosis (QLF).
  
  
  METHODS
  Axial HRCT images were acquired (1-mm slice thickness, 10-mm increments) in the prone position at inspiration. A validated model for quantifying interstitial disease patterns was applied to images from 83 subjects at baseline and 12 months. Scores were calculated for six zones (upper, mid, lower of the right/left lung) and the whole lung. Average changes were compared. Correlations were performed between QLF and physiological and clinical scores.
  
  
  RESULTS
  From the most severe zones identified at baseline, QLF scores decreased by 2.6% in the cyclophosphamide group, whereas they increased by 9.1% in the placebo group, leading to ~12% difference (p = 0.0027). Between-treatment difference in whole lung QLF was ~5% (p = 0.0190). Significant associations were observed between changes in QLF and FVC (r = -0.33), dyspnea score (r = -0.29), and consensus visual score (p = 0.0001).
  
  
  CONCLUSIONS
  QLF scores provide an objective quantitative tool for assessing treatment efficacy in scleroderma-related interstitial lung disease.
authors.affiliation: Center for Computer Vision and Imaging Biomarker, Department of Radiological Sciences, David Geffen School of Medicine, UCLA, 924 Westwood Blvd., Suite 650, Los Angeles, CA 90024-2926, USA. gracekim@mednet.ucla.edu
authors.forename: Hyun J
authors.initials: HJ
authors.lastname: Kim
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Brown
authors.forename: Robert
authors.initials: R
authors.lastname: Elashoff
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.forename: David W
authors.initials: DW
authors.lastname: Gjertson
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
authors.forename: Diane C
authors.initials: DC
authors.lastname: Strollo
authors.forename: Eric
authors.initials: E
authors.lastname: Kleerup
authors.forename: Daniel
authors.initials: D
authors.lastname: Chong
authors.forename: Sumit K
authors.initials: SK
authors.lastname: Shah
authors.forename: Shama
authors.initials: S
authors.lastname: Ahmad
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Abtin
authors.forename: Donald P
authors.initials: DP
authors.lastname: Tashkin
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Goldin
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000188:drug therapy; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D003520:Cyclophosphamide