Dataset Information

Novel Imaging Approaches in Systemic Sclerosis-Associated Interstitial Lung Disease.

ABSTRACT:

Purpose of the review

Novel imaging approaches, such as quantitative computed tomography (CT), magnetic resonance imaging (MRI), and molecular imaging, are being applied to interstitial lung diseases to provide prognostic, functional, and molecular information. Here, we review such imaging approaches and their applicability to systemic sclerosis-associated interstitial lung disease (SSc-ILD).

Recent findings

Quantitative CT can be used to quantify the radiographic response to SSc-ILD therapy. Due to advances in MRI sequence development, MRI can detect the presence of SSc-ILD with high accuracy. MRI can also be utilized to provide functional information as to SSc-ILD and paired with molecular probes to provide non-invasive molecular information. MRI and ultrasound have promising test characteristics for diagnosing ILD in SSc without the use of ionizing radiation. Novel imaging approaches can detect SSc-ILD without the use of ionizing radiation, provide non-invasive functional and molecular information, and quantify treatment response in SSc-ILD. These techniques hold promise for translation into clinical care and clinical trials.

SUBMITTER: Montesi SB

PROVIDER: S-EPMC7926189 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Novel Imaging Approaches in Systemic Sclerosis-Associated Interstitial Lung Disease.

Montesi Sydney B SB Caravan Peter P

Current rheumatology reports 20190425 6

<h4>Purpose of the review</h4>Novel imaging approaches, such as quantitative computed tomography (CT), magnetic resonance imaging (MRI), and molecular imaging, are being applied to interstitial lung diseases to provide prognostic, functional, and molecular information. Here, we review such imaging approaches and their applicability to systemic sclerosis-associated interstitial lung disease (SSc-ILD).<h4>Recent findings</h4>Quantitative CT can be used to quantify the radiographic response to SSc- ...[more]

PMID: 31025121

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Project description:Background: There are no effective treatments or validated clinical response markers in systemic sclerosis (SSc). We assessed imaging biomarkers and performed gene expression profiling in a single-arm open-label clinical trial of tyrosine kinase inhibitor dasatinib in patients with SSc-associated interstitial lung disease (SSc-ILD).Methods: Primary objectives were safety and pharmacokinetics. Secondary outcomes included clinical assessments, quantitative high-resolution computed tomography (HRCT) of the chest, serum biomarker assays and skin biopsy-based gene expression subset assignments. Clinical response was defined as decrease of >5 or >20% from baseline in the modified Rodnan Skin Score (MRSS). Pulmonary function was assessed at baseline and day 169.Results: Dasatinib was well-tolerated in 31 patients receiving drug for a median of nine months. No significant changes in clinical assessments or serum biomarkers were seen at six months. By quantitative HRCT, 65% of patients showed no progression of lung fibrosis, and 39% showed no progression of total ILD. Among 12 subjects with available baseline and post-treatment skin biopsies, three were improvers and nine were non-improvers. Improvers mapped to the fibroproliferative or normal-like subsets, while seven out of nine non-improvers were in the inflammatory subset (p = 0.0455). Improvers showed stability in forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO), while both measures showed a decline in non-improvers (p = 0.1289 and p = 0.0195, respectively). Inflammatory gene expression subset was associated with higher baseline HRCT score (p = 0.0556). Non-improvers showed significant increase in lung fibrosis (p = 0.0313).Conclusions: In patients with SSc-ILD dasatinib treatment was associated with acceptable safety profile but no significant clinical efficacy. Patients in the inflammatory gene expression subset showed increase in skin fibrosis, decreasing pulmonary function and worsening lung fibrosis during the study. These findings suggest that target tissue-specific gene expression analyses can help match patients and therapeutic interventions in heterogeneous diseases such as SSc, and quantitative HRCT is useful for assessing clinical outcomes.Trial registration: Clinicaltrials.gov NCT00764309.

Dataset Information

Novel Imaging Approaches in Systemic Sclerosis-Associated Interstitial Lung Disease.

Purpose of the review

Recent findings

Publications

Novel Imaging Approaches in Systemic Sclerosis-Associated Interstitial Lung Disease.

Similar Datasets

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