{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:53:25Z","timestamp":1791338005421,"version":"4.3.1"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Interstitial lung disease (ILD) is frequently complicated by pulmonary hypertension (PH), which is associated with reduced exercise capacity and poor prognosis. Early and accurate non-invasive detection of PH remains a clinical challenge. This study evaluated whether combining quantitative CT analysis of lung fibrosis with cardiac MRI-derived measures of right ventricular (RV) function improves the diagnostic accuracy of PH in patients with ILD. Methods: We retrospectively analyzed 72 ILD patients who underwent chest CT, cardiac MRI, and right heart catheterization (RHC). Lung fibrosis was quantified using a Gaussian Histogram Normalized Correlation (GHNC) software that computed the proportions of diseased lung, ground-glass opacity (GGO), honeycombing, reticulation, consolidation, and emphysema. MRI was used to assess RV end-systolic volume (RVESV), ejection fraction, and RV longitudinal strain. PH was defined as a mean pulmonary arterial pressure (mPAP) \u2265 20 mmHg and pulmonary vascular resistance \u2265 3 Wood units on RHC. Results: Compared to patients without PH, those with PH (n = 21) showed significantly reduced RV strain (\u221213.4 \u00b1 5.1% vs. \u221216.4 \u00b1 5.2%, p = 0.026) and elevated RVESV (74.2 \u00b1 18.3 mL vs. 59.5 \u00b1 14.2 mL, p = 0.003). CT-derived indices also differed significantly: diseased lung area (56.4 \u00b1 17.2% vs. 38.4 \u00b1 12.5%, p &lt; 0.001), GGO (11.8 \u00b1 3.6% vs. 8.65 \u00b1 4.3%, p = 0.005), and honeycombing (17.7 \u00b1 4.9% vs. 12.8 \u00b1 6.4%, p = 0.0027) were all more prominent in the PH group. In receiver operating characteristic curve analysis, diseased lung area demonstrated an area under the curve of 0.778 for detecting PH. This increased to 0.847 with the addition of RVESV, and further to 0.854 when RV strain was included. Combined models showed significant improvement in risk reclassification: net reclassification improvement was 0.700 (p = 0.002) with RVESV and 0.684 (p = 0.004) with RV strain; corresponding IDI values were 0.0887 (p = 0.03) and 0.1222 (p = 0.01), respectively. Conclusions: Combining CT-based fibrosis quantification with cardiac MRI-derived RV functional assessment enhances the non-invasive diagnosis of PH in ILD patients. This integrated imaging approach significantly improves diagnostic precision and may facilitate earlier, more targeted interventions in the management of ILD-associated PH.<\/jats:p>","DOI":"10.3390\/jcm14155329","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:50:03Z","timestamp":1753714203000},"page":"5329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Integrating CT-Based Lung Fibrosis and MRI-Derived Right Ventricular Function for the Detection of Pulmonary Hypertension in Interstitial Lung Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Kenichi","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naofumi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shungo","family":"Sawamura","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-653X","authenticated-orcid":false,"given":"Tae","family":"Iwasawa","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Ogura","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1723-1724","authenticated-orcid":false,"given":"Daisuke","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.cllc.2022.10.003","article-title":"Clinical Outcomes and Prognosis of Patients With Interstitial Lung Disease Undergoing Lung Cancer Surgery: A Propensity Score Matching Study","volume":"24","author":"Ki","year":"2023","journal-title":"Clin. 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