Idiopathic pulmonary fibrosis and progressive pulmonary fibrosis: correlation between radiological progression criteria and pulmonary function tests

UZUN Ç., Atman E. D., Çoruh A. G., ARSLAN F., Ekici P., Taşci F., ...Daha Fazla

European Journal of Radiology, cilt.195, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 195
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.ejrad.2025.112631
  • Dergi Adı: European Journal of Radiology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Anahtar Kelimeler: DLCO, FVC, Idiopathic pulmonary fibrosis, Progressive pulmonary fibrosis, Pulmonary function tests, Radiological progression, Usual interstitial pneumonia
  • Ankara Üniversitesi Adresli: Evet

Özet

Purpose The study aimed to evaluate the relationship between radiological progression criteria and pulmonary function tests (PFTs) and to identify which radiological marker best reflects functional decline. Material and methods A total of 112 patients were included: 61 with idiopathic pulmonary fibrosis (IPF) and 51 with progressive pulmonary fibrosis (PPF); 63 had a usual interstitial pneumonia (UIP) pattern and 49 a non-UIP pattern. Consecutive scans were compared, yielding 245 comparisons (138 UIP, 107 non-UIP) from 357 exams. Radiological progression was defined according to ATS/ERS/JRS/ALAT guidelines and compared with PFTs. Univariable and multivariable logistic regression analyses were performed to identify radiological predictors of PFT decline, with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Results In multivariable analysis, increased lobar volume loss was the only independent predictor of a ≥ 5 % decline in FVC in the UIP group (OR 6.673; 95 % CI: 2.270–19.609; p < 0.001), showing 65.5 % sensitivity, 84.4 % specificity, 76.9 % PPV, 75.5 % NPV, and 76 % accuracy. In the non-UIP group, significant predictors included new ground-glass opacity (GGO) with traction bronchiectasis (OR 5.043), increased extent or coarseness of reticular abnormality (OR 3.669), and increased lobar volume loss (OR 4.059), all statistically significant (p < 0.05). This model showed 65.3 % sensitivity, 82.8 % specificity, 76.2 % PPV, 73.9 % NPV, and 74.7 % accuracy. Conclusions Increased lobar volume loss was significantly associated with FVC decline in both UIP and non-UIP groups. When PFTs are unreliable or infeasible, increased lobar volume loss may serve as a reliable marker of functional deterioration. However, early radiologic progression may precede both volume loss and PFT changes, suggesting that HRCT can detect subtle disease progression more sensitively.