TITLE:
Progress in Quantitative Imaging Assessment of Dermatomyositis-Associated Interstitial Lung Disease
AUTHORS:
Hao Tu, Yuanyi Huang
KEYWORDS:
Idiopathic Inflammatory Myopathies (IIM), Interstitial Lung Disease (ILD), Anti-MDA5 Antibody, Rapidly Progressive ILD (RP-ILD), Quantitative Imaging Analysis (QIA), Radiomics, Risk Stratification
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.2,
February
13,
2026
ABSTRACT: Interstitial lung disease (ILD) is the primary pulmonary complication leading to disability and mortality in patients with systemic autoimmune rheumatic diseases (SARDs), particularly idiopathic inflammatory myopathies (IIMs). Among these, rapidly progressive ILD (RP-ILD) associated with anti-melanocyte differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM) carries an extremely poor prognosis, necessitating a precise risk stratification system in clinical practice. This paper systematically reviews recent advances in IIM-ILD, particularly MDA5+ DM-ILD. Regarding pathogenesis and prognosis, anti-MDA5 antibodies have been confirmed as independent risk factors for RP-ILD and high mortality. Biochemical markers including ferritin, LDH, hypouricemia, and sCD40L have been incorporated into multiparametric prediction models such as FLAIR, FLATCAN, and SMAD. Regarding diagnostic and monitoring technologies, high-resolution CT (HRCT) remains the gold standard, while quantitative image analysis (QIA), radiomics, and deep learning (DL) models now enable objective quantification of pulmonary parenchymal lesions and dynamic prognostic prediction. Additionally, novel biomarkers such as HE4 and pulmonary vascular-related structural parameters (PVRS) have been demonstrated to correlate significantly with ILD severity and progression rate, offering new entry points for imaging-biology cross-validation.