e-Lung CT Biomarkers Linked to ILD Prognosis
E-LUNG CT biomarkers were linked to mortality and future lung function decline in fibrotic interstitial lung diseases.
Automated computed tomography analysis may help clinicians identify higher risk patients with non-idiopathic pulmonary fibrosis interstitial lung disease, according to new findings evaluating the e-Lung weighted reticulovascular score.
The e-Lung weighted reticulovascular score, or WRVS, is an automated computed tomography biomarker designed to quantify interstitial lung disease severity. Previous work has associated WRVS with prognosis in patients with idiopathic pulmonary fibrosis, but its utility in non-IPF ILD has been less clear. This study examined whether baseline and serial WRVS could predict survival and forced vital capacity decline across two independent patient cohorts.
Baseline e-Lung CT Biomarkers Predicted Mortality
The analysis included a test cohort of 302 patients from the Open Source Imaging Consortium and a validation cohort of 378 patients recruited to the prospective German CoWorker ILD registry. Median survival was 7.1 years in the test cohort and 6.1 years in the validation cohort.
Baseline WRVS was significantly associated with mortality in both groups. In the test cohort, each increase in baseline WRVS was associated with higher mortality risk, with a hazard ratio of 1.11 and a C-index of 0.75. The association was similar in the validation cohort, where the hazard ratio was 1.12 and the C-index was 0.72.
A WRVS threshold of at least 15% identified patients at substantially higher risk. This threshold was associated with mortality in the test cohort, with a hazard ratio of 4.77, and in the validation cohort, with a hazard ratio of 3.49.
Serial CT Changes May Flag Higher Risk
The prognostic signal extended beyond survival. After adjustment for forced vital capacity, age, and sex, baseline WRVS was associated with future forced vital capacity decline or death in both cohorts. The odds ratio was 1.13 in the test cohort and 1.18 in the validation cohort, with C-index values of 0.72 in both analyses.
Serial computed tomography added further risk information. A 3% rise in WRVS was associated with mortality in both cohorts, although the strength of association differed. The hazard ratio was 5.69 in the test cohort and 1.99 in the validation cohort.
Together, these data suggest that e-Lung CT biomarkers may provide a reproducible, imaging-based approach to risk stratification in fibrotic interstitial lung diseases beyond idiopathic pulmonary fibrosis. The findings support further evaluation of automated CT biomarkers as tools for monitoring disease progression and identifying patients who may require closer follow-up.
Reference
Abbasi Dezfouli K et al. e-Lung computed tomography biomarkers are associated with outcomes in fibrotic interstitial lung diseases. ERJ Open Res. 2026;12(3):01058-2025.
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