Association between body fat decrease during the first year after diagnosis and the prognosis of idiopathic pulmonary fibrosis: CT-based body composition analysis

Lee et al. investigated the prognostic impact of body fat changes within the first year after an idiopathic pulmonary fibrosis (IPF) diagnosis. This retrospective study included 307 IPF patients who underwent CT scans and pulmonary function tests (PFTs). Using the DEEP-CATCH software for body composition analysis and AVIEW Lung Texture software to quantify lung abnormalities, body fat areas were measured at baseline and after one year at the T12-L1 level. AVIEW segmented lung parenchyma to assess IPF extent, defining it as a combination of ground-glass, reticular, and honeycombing opacities. Results indicated that patients who lost ≥52.3 cm² in fat area within the first year had a higher risk of adverse outcomes (death or lung transplantation), with a hazard ratio of 1.566, while BMI changes were not predictive. This study suggests that CT-based body composition and lung texture analysis may offer a more accurate prognosis in IPF, warranting further multi-center validation to confirm findings.