Quantitative chest computed tomography is associated with two prediction models of mortality in interstitial lung disease related to systemic sclerosis.
In this multicentre study, we aimed to evaluate the capacity of a computer-assisted automated QCT method to identify patients with SSc-associated interstitial lung disease (SSc-ILD) with high mortality risk according to validated composite clinical indexes (ILD-Gender, Age, Physiology index and du Bois index).



Chest CT, anamnestic data and pulmonary function tests of 146 patients with SSc were retrospectively collected, and the ILD-Gender, Age, Physiology score and DuBois index were calculated. Each chest CT underwent an operator-independent quantitative assessment performed with a free medical image viewer (Horos). The correlation between clinical prediction models and QCT parameters was tested. A value of P < 0.05 was considered statistically significant.



Most QCT parameters had a statistically different distribution in patients with diverging mortality risk according to both clinical prediction models (P < 0.01). The cut-offs of QCT parameters were calculated by receiver operating characteristic curve analysis, and most of them could discriminate patients with different mortality risk according to clinical prediction models.



QCT assessment of SSc-ILD can discriminate between well-defined different mortality risk categories, supporting its prognostic value. These findings, together with the operator independence, strengthen the validity and clinical usefulness of QCT for assessment of SSc-ILD.
Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero.
Alarico
A
Ariani
Department of Clinical Sciences, Section of Radiology, University of Parma, Parma.
Mario
M
Silva
Department of Clinical Sciences, Section of Radiology, University of Parma, Parma.
Valeria
V
Seletti
Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza.
Elena
E
Bravi
Rheumatology Unit, Ospedale Mauriziano - Umberto I di Torino, Turin.
Marta
M
Saracco
Rheumatology Department, Azienda Ospedaliera Cittá della Salute e della Scienza di Torino, Turin.
Simone
S
Parisi
Rheumatology Unit, Azienda Ospedaliera 'Istituti Ospitalieri' di Cremona, Cremona.
Fabio
F
De Gennaro
Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona.
Luca
L
Idolazzi
Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona.
Paola
P
Caramaschi
Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona.
Camilla
C
Benini
Radiology Unit, Ospedale G. Da Saliceto, Piacenza.
Flavio Cesare
FC
Bodini
Epidemiology Unit, Italian Society for Rheumatology, Milano.
Carlo Alberto
CA
Scirè
Epidemiology Unit, Italian Society for Rheumatology, Milano.
Greta
G
Carrara
Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena.
Federica
F
Lumetti
Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy.
Veronica
V
Alfieri
Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy.
Elisa
E
Bonati
Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero.
Gianluca
G
Lucchini
Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy.
Marina
M
Aiello
Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero.
Daniele
D
Santilli
Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero.
Flavio
F
Mozzani
Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza.
Davide
D
Imberti
Radiology Unit, Ospedale G. Da Saliceto, Piacenza.
Emanuele
E
Michieletti
Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza.
Eugenio
E
Arrigoni
Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero.
Giovanni
G
Delsante
Rheumatology Unit, Ospedale Mauriziano - Umberto I di Torino, Turin.
Raffaele
R
Pellerito
Rheumatology Department, Azienda Ospedaliera Cittá della Salute e della Scienza di Torino, Turin.
Enrico
E
Fusaro
Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy.
Alfredo
A
Chetta
Department of Clinical Sciences, Section of Radiology, University of Parma, Parma.
Nicola
N
Sverzellati
D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging* / Q000401:mortality; D014057:Tomography, X-Ray Computed / Q000401:mortality
Horos; OsiriX; interstitial lung disease; mortality risk model.; pulmonary fibrosis; quantitative chest CT; systemic sclerosis