Katelynn Maries Wilton BS, Presenter: Nothing to Disclose

Brian Jack Bartholmai MD, Abstract Co-Author: Nothing to Disclose

Sanjay Kalra MD, Abstract Co-Author: Nothing to Disclose

Cynthia S. Crowson MS, Abstract Co-Author: Nothing to Disclose

Sushravya Raghunath, Abstract Co-Author: Nothing to Disclose

Srinivasan Rajagopalan PhD, Abstract Co-Author: Nothing to Disclose

Floranne Ernste MD, Abstract Co-Author: Nothing to Disclose

In idiopathic inflammatory myopathy (IIM), interstitial lung disease (ILD) is a major cause of morbidity and mortality. ILD in IIM may manifest with a variety of pathological and radiographic abnormalities . Most ILD subtypes have characteristic clinical and radiographic features; hence, diagnosis is usually aided by expert radiologist assessment. Radiography and pulmonary function tests (PFT) may provide a qualitative measurement of severity. However, CT evaluation is subject to inter- and intra-observer variability. PFT results can be influenced by patient effort and do not differentiate specific restrictive pulmonary pathologies. We hypothesize that Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) software, which characterizes CT parenchyma, can help predict clinical outcomes, objectively quantify extent of ILD in IIM and help in disease monitoring.

CALIPER was utilized to quantify ILD features on CT in 172 subjects with IIM. We retrospectively collected demographic, PFT and medication data at baseline, years 1, 3 and 5. IIM-related mortality was retrospectively assessed.

CALIPER detected diverse parenchymal involvement, with variable quantities of uninvolved parenchyma, ground glass opacities, reticular densities, honeycombing and low attenuation areas. In 95% of patients, CALIPER detected ≥5% parenchymal abnormalities characteristic of ILD. Compared to treated patients, untreated patients had more baseline parenchymal abnormalities. The treated cohort showed improvement in quantity of reticular densities (year 1, 3) and total interstitial abnormalities (year 1), while our untreated subgroup showed worsening interstitial abnormalities (year 3).

CALIPER analysis, including identification and quantification of baseline ILD and detection of change, in parenchymal involvement may prove to be a useful clinical tool in patients with IIM.

Detection and monitoring of ILD progression in patients with IIM can better inform the use of immunomodulatory treatments, both in the clinic and in future research trials.

Wilton, K, Bartholmai, B, Kalra, S, Crowson, C, Raghunath, S, Rajagopalan, S, Ernste, F, Quantification of Interstitial Lung Disease in Idiopathic Inflammatory Myopathy Patients Using the “Computer-Aided Lung Informatics for Pathology Evaluation and Rating” (CALIPER) Software System.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014575.html