Prognostic Impact of Radiologic and Pathologic Features on the Development of Progressive Pulmonary Fibrosis in Patients With Interstitial Lung Disease Other Than Idiopathic Pulmonary Fibrosis

Q: Which imaging and clinical factors were associated with the development of progressive pulmonary fibrosis (PPF)?

Traction bronchiectasis on CT and body mass index (BMI) were significantly associated with PPF in multivariable analysis.

Q: What factors were significantly associated with death in patients with non-IPF ILD?

Radiological progression, symptomatic progression, and age (per 1-year increase) were significantly associated with all-cause mortality.

Q: How was time to PPF and overall survival analyzed in the study?

Time to PPF and overall survival were estimated using the Kaplan-Meier method, and associations were tested with Cox regression and time-dependent Cox models.

Sep 30, 2026

Uploaded by Anna Hans

Objective evaluates how radiologic and pathologic findings influence prognosis in interstitial lung disease (ILD) patients other than idiopathic pulmonary fibrosis (IPF), focusing on predictors of progressive pulmonary fibrosis (PPF) and overall survival. A retrospective cohort of 75 non-IPF ILD patients who underwent surgical lung biopsy (2004–2020) was reviewed on preoperative and follow-up CT and histopathology. Traction bronchiectasis on CT and body mass index related to PPF, while radiologic progression, symptomatic progression, and older age related to mortality. Findings support careful imaging review and symptom monitoring to anticipate disease progression and outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Objective

Materials and Methods

Results

Conclusion

Keywords

Original Article | Thoracic Imaging eISSN 2005-8330 [https://doi.org/10.3348/kjr.2025.0977](https://doi.org/10.3348/kjr.2025.0977) [Korean J Radiol 2026](Korean J Radiol 2026);[27](27)([1](1))[:63-75](:63-75) Prognostic Impact of Radiologic and Pathologic Features on the Development of Progressive Pulmonary Fibrosis in Patients With Interstitial Lung Disease Other Than Idiopathic Pulmonary Fibrosis Hyeong Ryun Cho1 *, Myoung Ja Chung2 *, Hyemi Choi3, Jinheum Kim4, Ae Ri An2, Su Yeon Ahn5, Jin Young Yoo6, Gong Yong Jin1, David A Lynch7, Kum Ju Chae1 1 Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea 2 Department of Pathology, Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea 3 Department of Statistics and Institute of Applied Statistics, Jeonbuk National University, Jeonju, Republic of Korea 4 Department of Applied Statistics, University of Suwon, Hwaseong, Republic of Korea 5 Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea 6 Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 7 Department of Radiology, National Jewish Health, Denver, CO, USA Objective: To evaluate the prognostic impact of radiologic and pathologic features in patients with interstitial lung disease (ILD) other than idiopathic pulmonary fibrosis (IPF), and to identify the factors associated with the development of progressive pulmonary fibrosis (PPF) and survival. Materials and Methods: This study retrospectively enrolled 75 patients diagnosed with ILD other than IPF who underwent surgical lung biopsy between January 2004 and December 2020. Three chest radiologists independently reviewed the CT features and extent of fibrosis on preoperative and follow-up CT scans. Two pathologists reviewed the histopathological features, including the presence of interstitial pneumonia. The time to PPF and overall survival were estimated using the Kaplan-Meier method. The associations of CT and pathological features with PPF and all-cause mortality were examined using standard Cox regression and time-dependent Cox models, respectively. Results: A total of 75 non-IPF ILD patients (mean age ± standard deviations 56.4 ± 13.2 years; range, 40–88 years) were enrolled. The median follow-up duration was 75.3 months (range, 7.8–189.8 months) . Traction bronchiectasis on CT (adjusted hazard ratio [HR], 6.40; P = 0.003) and body mass index (adjusted HR per 1-kg/m2 increase, 0.82; P = 0.002) were found to be significantly associated with PPF in multivariable analysis. Radiological progression (adjusted HR, 18.44; P < 0.001), symptomatic progression (adjusted HR, 4.19; P = 0.011), and age (adjusted HR for 1-year increase, 1.12; P < 0.001) were significantly associated with death. Conclusion: Traction bronchiectasis on CT was a significant predictor of PPF, while radiologic and symptomatic progression and older age were associated with poorer survival in patients with ILD other than IPF. These findings indicate that careful radiological evaluation and symptom monitoring may help to predict disease progression and outcomes in patients with nonIPF ILD. Keywords: Interstitial lung disease; Progressive pulmonary fibrosis; Disease progression; Survival; Traction bronchiectasis Received: July 9, 2025 Revised: October 16, 2025 Accepted: November 5, 2025 *These authors contributed equally to this work. Corresponding author: Kum Ju Chae, MD, PhD, Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Rep

FAQs

Which imaging and clinical factors were associated with the development of progressive pulmonary fibrosis (PPF)?

Traction bronchiectasis on CT and body mass index (BMI) were significantly associated with PPF in multivariable analysis.

What factors were significantly associated with death in patients with non-IPF ILD?

Radiological progression, symptomatic progression, and age (per 1-year increase) were significantly associated with all-cause mortality.

How was time to PPF and overall survival analyzed in the study?

Time to PPF and overall survival were estimated using the Kaplan-Meier method, and associations were tested with Cox regression and time-dependent Cox models.

Sep 30, 2026

Uploaded by Anna Hans