{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:28:08Z","timestamp":1786980488891,"version":"build-2736575974"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011644","name":"Kahramanmaras Sutcu Imam University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011644","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the ability of quantitative parameters to assess the severity of rheumatoid arthritis (RA)\u2013associated interstitial lung disease (ILD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thorax CT images and pulmonary function tests of RA patients followed up in a tertiary reference center were retrospectively examined. Radiologically, patients were divided into two groups as limited and extensive ILD, using two semiquantitative scoring systems. Two different methods (Method 1, Method 2) were used for quantitative image analysis, in which different Hounsfield unit values were selected as thresholds. Spearman\u2019s correlation test was used to evaluate the relationship between variables. The diagnostic performance of quantitative methods for the ability to distinguish limited ILD from extensive ILD was calculated using ROC analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-four patients, 29 female and 15 male, were included in the study. A significant correlation was found between diffusion capacity of the lungs carbonmonoxide (DLCO) and total lung capacity (TLC), which are clinical markers, and both quantitative methods (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In terms of the performance of diagnostic tests, the power of Method 1 and Method 2 to distinguish limited and extensive disease classified based on semiquantitative scores was found to be strong (Method 1 AUC\u2009=\u20090.945, Method 2 AUC\u2009=\u20090.785 based on \u201cILD score\u201d; Method 1 AUC\u2009=\u20090.911, Method 2 AUC\u2009=\u20090.700 based on \u201cmodified coarseness of reticular disease (MCRD) score\u201d).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study demonstrates that quantitative methods (Method 1 [\u2212\u2009700 to\u2009\u2212\u2009200 HU] and Method 2 [\u2212\u2009800 to\u2009\u2212\u2009500 HU]) play a significant role in assessing the severity of RA-associated ILD (RA-ILD). Both methods showed significant correlations with pulmonary function tests (DLCO [\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      \u2009= \u2212\u20090.338,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      \u2009=\u20090.025;\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>2<\/jats:sub>\n                      \u2009= \u2212\u20090.452,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>2<\/jats:sub>\n                      \u2009=\u20090.002] and TLC [\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      \u2009= \u2212\u20090.567,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>2<\/jats:sub>\n                      \u2009= \u2212\u20090.576,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>2<\/jats:sub>\n                      \u2009&lt;\u20090.001), with Method 1 (AUC\n                      <jats:sub>ILD<\/jats:sub>\n                      \u2009=\u20090.945 and AUC\n                      <jats:sub>MCRD<\/jats:sub>\n                      \u2009=\u20090.911) demonstrating superior performance in distinguishing between limited and extensive ILD. Our findings suggest that Hounsfield unit threshold\u2013based quantitative CT analysis may serve as a more objective and reproducible alternative to semiquantitative systems (e.g., Goh score) in the standard evaluation of RA-ILD. Specifically, Method 1 may enable early detection of progression by mechanism, e.g., \u201ctracking subtle density changes.\u201d However, further validation in multicenter prospective cohorts is needed to address limitations such as bias.\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td colspan=\"2\">\n                                <jats:bold>Key Points<\/jats:bold>\n                                \u2022\n                                <jats:italic>Interobserver and intraobserver variability\u00a0poses a significant challenge in the objective assessment of rheumatoid arthritis\u2013associated interstitial lung disease<\/jats:italic>\n                                .\u2022\n                                <jats:italic>User independent quantitative methods can be used instead of user-dependent semiquantitative methods in assessing rheumatoid arthritis\u2013associated interstitial lung disease<\/jats:italic>\n                                .\u2022\n                                <jats:italic>Quantitative\u00a0computed tomography analysis\u00a0enables precise stratification of disease severity in rheumatoid arthritis-associated interstitial lung disease, distinguishing limited interstitial lung disease from extensive interstitial lung disease, which has a poor prognosis<\/jats:italic>\n                                .\n                              <\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-025-07511-y","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T06:58:20Z","timestamp":1749452300000},"page":"2669-2681","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Computed tomography-based quantitative scoring system for rheumatoid arthritis\u2013associated interstitial lung disease: a retrospective diagnostic accuracy study for progressive fibrosis detection"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8510-4866","authenticated-orcid":false,"given":"Mehmet Cihan","family":"Karacao\u011flu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2567-4330","authenticated-orcid":false,"given":"Bet\u00fcl","family":"K\u0131z\u0131lda\u011f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-9930","authenticated-orcid":false,"given":"Burak","family":"Okyar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9680-7535","authenticated-orcid":false,"given":"G\u00f6zde","family":"Y\u0131ld\u0131r\u0131m \u00c7etin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-9350","authenticated-orcid":false,"given":"Adem","family":"Do\u011faner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4127-4924","authenticated-orcid":false,"given":"Nurhan","family":"Atilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"issue":"10","key":"7511_CR1","doi-asserted-by":"publisher","first-page":"e594","DOI":"10.1016\/S2665-9913(23)00211-4","volume":"5","author":"RJ Black","year":"2023","unstructured":"Black RJ, Cross M, Haile LM, Culbreth GT, Steinmetz JD, Hagins H et al (2023) Global, regional, and national burden of rheumatoid arthritis, 1990\u20132020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. 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