{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T04:25:41Z","timestamp":1780806341652,"version":"3.54.1"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Elexacaftor\u2013tezacaftor\u2013ivacaftor (ETI) has shown clinical and spirometric benefits in cystic fibrosis (CF). CT remains a vital tool for diagnosing and monitoring structural lung disease. This study aimed to assess the evolution of lung disease, as evaluated through CT, in adults with CF after at least one year of ETI treatment. This ambispective observational analysis assessed lung CT scans performed before initiating ETI and after at least one year of treatment, using the modified Bhalla scoring system. For those patients with an earlier CT scan, a pre-treatment phase analysis was performed. Epidemiological, clinical, and functional parameters were evaluated. Results: Sixty-two patients were included (35 males, median age 30.4 \u00b1 7.87 years). After at least one year of ETI, significant improvements were observed in the global CT Bhalla score (12.2 \u00b1 2.8 vs. 14.0 \u00b1 2.8), peribronchial thickening (1.4 \u00b1 0.6 vs. 1.0 \u00b1 0.4), and mucus plugging (1.6 \u00b1 0.7 vs. 0.8 \u00b1 0.6) (p &lt; 0.001). Spirometry parameters increased significantly: the percentage of the predicted forced expiratory volume in the first second (ppFEV1) increased from 66.5 \u00b1 19.8 to 77.0 \u00b1 20.4 (p = 0.005) and forced vital capacity (ppFVC) from 80.6 \u00b1 16.4 to 91.6 \u00b1 14.1 (p &lt; 0.001). Additionally, body mass index showed a significant increase. A moderate correlation was found between the Bhalla score and spirometry results. In the pre-treatment phase (n = 52), mucus plugging demonstrated a significant worsening, whereas global CT score, other subscores, and spirometry did not change significantly. Conclusions: In adults with CF, after at least one year of ETI, a significant improvement in structural lung disease was achieved, as reflected by the CT Bhalla score.<\/jats:p>","DOI":"10.3390\/jimaging11040124","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T20:38:26Z","timestamp":1745267906000},"page":"124","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evolution of Lung Disease Studied by Computed Tomography in Adults with Cystic Fibrosis Treated with Elexacaftor\/Tezacaftor\/Ivacaftor"],"prefix":"10.3390","volume":"11","author":[{"given":"Susana","family":"Hern\u00e1ndez-Mu\u00f1iz","sequence":"first","affiliation":[{"name":"Radiology Department, University Hospital La Princesa, Calle Diego de Leon n\u00ba 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6352-9994","authenticated-orcid":false,"given":"Paloma","family":"Caballero","sequence":"additional","affiliation":[{"name":"Radiology Department, University Hospital La Princesa, Calle Diego de Leon n\u00ba 62, 28006 Madrid, Spain"},{"name":"Medicine Department, Universidad Aut\u00f3noma, 28049 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Sol\u00eds-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pneumonology Department, University Hospital La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7368-4720","authenticated-orcid":false,"given":"Carmen","family":"de Benavides","sequence":"additional","affiliation":[{"name":"Radiology Department, University Hospital La Princesa, Calle Diego de Leon n\u00ba 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Collada","sequence":"additional","affiliation":[{"name":"Radiology Department, University Hospital La Princesa, Calle Diego de Leon n\u00ba 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4895-9689","authenticated-orcid":false,"given":"Ignacio","family":"D\u00edaz-Lorenzo","sequence":"additional","affiliation":[{"name":"Radiology Department, University Hospital La Princesa, Calle Diego de Leon n\u00ba 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Zorzo","sequence":"additional","affiliation":[{"name":"Radiology Department, University Hospital Sanitas La Moraleja, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Mar","family":"G\u00f3mez-Punter","sequence":"additional","affiliation":[{"name":"Pneumonology Department, University Hospital La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7094-0848","authenticated-orcid":false,"given":"Rosa Mar\u00eda","family":"Gir\u00f3n","sequence":"additional","affiliation":[{"name":"Pneumonology Department, University Hospital La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4187\/respcare.06697","article-title":"Cystic fibrosis lung disease: An overview","volume":"65","author":"Turcios","year":"2020","journal-title":"Respir. 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