Computed Tomography Findings in Pathological Usual Interstitial Pneumonia

Sumikawa, Hiromitsu; Johkoh, Takeshi; Colby, Thomas V.; Ichikado, Kazuya; Suga, Moritaka; Taniguchi, Hiroyuki; Kondoh, Yasuhiro; Ogura, Takashi; Arakawa, Hiroaki; Fujimoto, Kiminori; Inoue, Akira; Mihara, Naoki; Honda, Osamu; Tomiyama, Noriyuki; Nakamura, Hajime; Müller, Néstor L.

doi:10.1164/rccm.200611-1696oc

Cited by 327 publications

(278 citation statements)

References 20 publications

(32 reference statements)

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“…A number of other studies suggest that the extent of fibrosis assessed semiquantitatively on HRCT is a strong predictor of outcomes in IPF [1,4,17]. Correlation of quantitative estimates of pulmonary fibrosis by automated analysis to mortality has been the object of few reports [1,18,19].…”

Section: Discussionmentioning

confidence: 99%

Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis

Maldonado

Moua

Rajagopalan³

et al. 2013

European Respiratory Journal

194

139

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Accurate assessment of prognosis in idiopathic pulmonary fibrosis remains elusive due to significant individual radiological and physiological variability. We hypothesised that short-term radiological changes may be predictive of survival.We explored the use of CALIPER (Computer-Aided Lung Informatics for Pathology Evaluation and Rating), a novel software tool developed by the Biomedical Imaging Resource Laboratory at the Mayo Clinic Rochester (Rochester, MN, USA) for the analysis and quantification of parenchymal lung abnormalities on high-resolution computed tomography. We assessed baseline and follow-up (time-points 1 and 2, respectively) high-resolution computed tomography scans in 55 selected idiopathic pulmonary fibrosis patients and correlated CALIPER-quantified measurements with expert radiologists' assessments and clinical outcomes.Findings of interval change (mean 289 days) in volume of reticular densities (hazard ratio 1.91, p50.006), total volume of interstitial abnormalities (hazard ratio 1.70, p50.003) and per cent total interstitial abnormalities (hazard ratio 1.52, p50.017) as quantified by CALIPER were predictive of survival after a median follow-up of 2.4 years. Radiologist interpretation of short-term global interstitial lung disease progression, but not specific radiological features, was also predictive of mortality.These data demonstrate the feasibility of quantifying interval short-term changes on high-resolution computed tomography and their possible use as independent predictors of survival in idiopathic pulmonary fibrosis. @ERSpublications Short-term quantified CT changes are predictive of survival in IPF

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Section: Discussionmentioning

confidence: 99%

Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis

Maldonado

Moua

Rajagopalan³

et al. 2013

European Respiratory Journal

194

139

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“…First, prereading of all images was performed (by KT and KI). Based on this prereading and the established imaging components of thoracic CT scans (21,22), the items to be studied were determined.…”

Section: Methodsmentioning

confidence: 99%

“…After 3 pulmonologists reached consensus on the definitions of these components by referring to the literature (21,22) and discussing both representative and controversial images, all sets of CT images were read independently for the presence/ absence of these components. Finally, CT images were read again by 3 pulmonologists, and consensus was reached by discussing the presence or absence of these components in individual patients.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

Yamagata

Ikeda

Tsushima

et al. 2016

Arthritis & Rheumatology

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Objective. To determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics and mortality.Methods. We retrospectively identified 167 consecutive hospital-based patients with MPA in 3 hospitals in Japan. We longitudinally collected clinical information for 150 of these patients, for whom CT images obtained before treatment were available. We then determined the presence of 22 imaging components of lung abnormalities in these patients.Results. The vast majority of patients (97%) had at least 1 lung abnormality on chest CT images, including interstitial lung lesions (66%), airway lesions (66%), pleural lesions (53%), and emphysematous lesions (37%). In multivariate analyses, ground-glass opacity was associated with the Birmingham Vasculitis Activity Score, whereas 3 of 4 airway lesions were associated with myeloperoxidase-antineutrophil cytoplasmic antibodies. Latent class analysis identified a distinct group of patients with airwaypredominant lung lesions. Airway lesions such as bronchiolitis and bronchovascular bundle thickening were among the components that showed improvement within 3 months of the initial treatment. An idiopathic pulmonary fibrosis pattern was the only chest CT variable that was independently associated with shorter survival.Conclusion. Abnormalities in a wide range of anatomic areas, including the whole airway, can be identified in the lungs of patients with MPA before treatment. The prevalence, clustering patterns, and responsiveness to treatment of individual lung abnormalities provide groundwork for informing future studies to understand the pathophysiology of MPA.Microscopic polyangiitis (MPA) is a necrotizing systemic vasculitis that affects small to medium-sized vessels. In MPA, immune deposits on the vessel wall are usually absent, and serum antineutrophil cytoplasmic antibodies (ANCAs) are frequently present. MPA shares these

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“…In human IPF, the search for prognostic factors has been extensive as the course of the disease can vary greatly among patients, from rapidly to slowly progressive to a step‐like process 6. Several factors have been associated with poor survival in humans, including decreased walking distance in 6‐minute walk test (6MWT),8 increasing grade of interstitial fibrosis on thoracic radiographs,9 fibrosis score and traction bronchiectasis in thin‐section computed tomography,10 increased bronchoalveolar lavage (BAL) neutrophilia,11 and presence of pulmonary hypertension 12. In human IPF with a step‐like progression, periods of relative stability are interrupted by acute exacerbations (AEs), which are associated with high mortality and a histopathologic pattern of diffuse alveolar damage (DAD) 6.…”

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confidence: 99%

Long‐Term Outcome and Use of 6‐Minute Walk Test in West Highland White Terriers with Idiopathic Pulmonary Fibrosis

Lilja‐Maula

Laurila

Syrjä

et al. 2014

Veterinary Internal Medicne

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BackgroundIdiopathic pulmonary fibrosis (IPF) is an incurable interstitial lung disease occurring mainly in West Highland White Terriers (WHWTs). The effects of IPF on survival and on exercise tolerance in WHWTs are unknown.ObjectivesTo evaluate survival, prognostic factors, and exercise tolerance in WHWTs with IPF.AnimalsPrivately owned WHWTs; 15 with IPF and 11 healthy controls.MethodsProspective case‐control study conducted in 2007–2012. For survival, descriptive statistics and Kaplan–Meier (KM) survival curves with Cox proportional hazard ratios were performed. For the prognostic factor study, KM curves, Cox regression analysis, and logistic regression models were used. The 6‐minute walk test (6MWT) was used for measurement of exercise tolerance.ResultsThe median IPF‐specific survival of deceased WHWTs (7/15) with IPF was 32 (range 2–51) months from onset of clinical signs. The risk of death from birth in WHWTs with IPF in age‐adjusted Cox model was significantly higher (hazard ratio 4.6; 95% confidence interval 1.05–19.74, P = .04) than in control WHWTs. No significant prognostic factors were identified. In 6MWT, WHWTs with IPF walked a shorter distance, median 398 m (range 273–519 m), than healthy controls, median 492 m (420–568 m), P = .05, and the partial pressure of oxygen in arterial blood in diseased dogs had a moderate positive correlation with walking distance (Kendall′s tau‐b = 0.69, P = .06).Conclusion and Clinical Importance IPF had a negative impact on life expectancy, but individual survival varied considerably. 6MWT proved to be a well‐tolerated, noninvasive test to evaluate exercise tolerance.

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Computed Tomography Findings in Pathological Usual Interstitial Pneumonia

Abstract: In patients with IPF and UIP pattern on the biopsy, the pattern of abnormality on thin-section CT, whether characteristic of UIP or suggestive of alternative diagnosis, does not influence prognosis. Prognosis is influenced by traction bronchiectasis and fibrosis scores.

Cited by 327 publications

References 20 publications

Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis

Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis

Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

Long‐Term Outcome and Use of 6‐Minute Walk Test in West Highland White Terriers with Idiopathic Pulmonary Fibrosis

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