Quantitative assessment of interstitial lung disease in rheumatoid arthritisEvaluación cuantitativa de la enfermedad pulmonar intersticial en la artritis reumatoide
Por:
Bertolazzi C., Silva M., Rojas-Serrano J., Ramos-Martínez E., Carnevale A., Sverzellati N., Gutierrez M., Alfaro-Rodriguez A., Ariani A.
Publicada:
1 ene 2026
Resumen:
© 2026 Sociedad Española de Reumatología (SER), Colegio Mexicano de Reumatología (CMR) y Elsevier España, S.L.U.Background: Interstitial lung disease (ILD) is the most common pulmonary affection of rheumatoid arthritis (RA). Patients with a severe RA-ILD extent i.e. >20% according to chest Computed Tomography (CT) semiquantitative (SQCT) scores, have poor prognosis. Quantitative CT (QCT) assessment with operator independent methods based on free software represents a reliable solution already tested in other ILD related to rheumatic diseases. Objectives: The main objective of this monocentric study is to verify if in RA-ILD there is a correlation between QCT and SQCT performed by experienced radiologists. Secondary aims are: (a) to explore if there is a difference of QTC indexes (QCTi) in RA-ILD patients with severe vs mild ILD extent; (b) to evaluate the discriminative ability of QCT in identifying severe RA-ILD patients. Materials and methods: The chest CTs of consecutive RA-ILD underwent to a SQCT assessment by two experienced chest radiologists. All CTs were also blindly post-processed by a rheumatologist in order to obtain the QCTi. QCTi correlations, distribution and discriminative ability were, respectively, verified using Spearman rank test, Mann–Whitney test and ROC curves. Results: The majority of QCTi showed a moderate degree (0.40 < r < 0.59) with SQCT assessment (p-value < 0.01). Patients with severe and mild ILD had dissimilar QCTi values (p = 0.001). Almost all of QCTi had a good discriminative ability (AUC from 0.73 to 0.81, p-value = 0.0001). Conclusions: These preliminary findings suggest that RA-ILD extent is related to QCTi. Moreover, QCTi can discriminate very well patients with a severe ILD. So, QCTi may become simple tools quickly estimate RA-ILD prognosis.
Filiaciones:
Rheumatology Division, Instituto Nacional de Rehabilitacion, Mexico City, Mexico
Department of Clinical Sciences, Section of Radiology, University of Parma, Parma, Italy
Interstitial Lung disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
Experimental Medicine Research Unit, Facultad de Medicina, Universidad Nacional Autónoma de México, 06720 México City, Mexico
Morphology, Surgery and Experimental Medicine Department, Diagnostic Imaging Section, University of Ferrara, Ferrara, Italy
Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación, Mexico City, Mexico
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