A team of researchers examined the use of quantitative 3D CT imaging to assess lung volume (LV) changes in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) during acute exacerbations (AE), which are linked to high morbidity and mortality. A multicenter cohort study included patients with RA-ILD at diagnosis (n=54), AE (discovery cohort, n=20; validation cohort, n=33), and controls (n=35). Results, which the researchers reported online in Rheumatology, indicated significant LV reduction, especially in the lower lobes, at diagnosis and further substantial volume loss in both upper and lower lobes during AE. Decreased standardized LV on 3D CT was strongly associated with worse prognosis and identified as an independent prognostic factor for mortality. The study authors said a composite model combining age and standardized LV effectively stratified mortality risk.