Diagnosis of idiopathic pulmonary fibrosis with high-resolution CT in patients with little or no radiological evidence of honeycombing: secondary analysis of a randomised, controlled trial

Raghu, Ganesh; Lynch, David A.; Godwin, J. David; Webb, Richard; Colby, Thomas V.; Leslie, Kevin O.; Behr, Jüergen; Brown, Kevin K.; Egan, J. J.; Flaherty, Kevin R.; Martínez, Fernando J.; Wells, Athol U.; Shao, Lixin; Hong, Zhou; Pedersen, Patricia; Sood, Rohit; Montgomery, A. Bruce; O’Riordan, Thomas G.

doi:10.1016/s2213-2600(14)70011-6

Cited by 165 publications

(115 citation statements)

References 20 publications

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“…A majority of patients in our cohort had possible UIP patterns of HRCT, indicating a greater risk for the development of pathological UIP. These findings were in accordance with those of a previous report (24). We need future studies of patients with surgical biopsy to identify the criteria for a definite diagnosis of the possible UIP (25).…”

Section: Discussionsupporting

confidence: 91%

Clinical characteristics of idiopathic pulmonary fibrosis patients according to their smoking status

Kishaba¹,

Nagano²,

Nei³

et al. 2016

J. Thorac. Dis.

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Background: Idiopathic pulmonary fibrosis (IPF) is the most common form of idiopathic interstitial pneumonias (IIPs) of unknown etiology that often affects male, elderly smokers. However, it is sometimes observed in never smokers. This study aimed to clarify the clinical characteristics of IPF in never-smoking patients compared with those in smoking patients. Methods:We retrospectively reviewed medical records, pulmonary function tests, and chest highresolution computed tomography (HRCT) scan of never-smoking and smoking IPF patients from July 1, 2008 to June 30, 2013 at our hospital.Results: We identified 32 never-smoking IPF patients and 66 smoking IPF patients. Never-smoking IPF patients developed more acute exacerbation (AE) than smoking IPF patients (50% vs. 18.2%, P<0.0001). Conclusions:In conclusion, never-smoking IPF patients developed AE more often and showed poor prognosis compared with smoking IPF patients. The 1-year mMRC breathlessness scale was an important predictor of mortality at our hospital.

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Section: Discussionsupporting

confidence: 91%

Clinical characteristics of idiopathic pulmonary fibrosis patients according to their smoking status

Kishaba¹,

Nagano²,

Nei³

et al. 2016

J. Thorac. Dis.

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“…HRCT scanning can provide a confident, highly specific diagnosis of IPF in ∼50-60% of patients with diffuse lung disease [14][15][16]. In the remaining 40-50% of patients with suspected IPF, HRCT findings do not reveal a typical UIP pattern.…”

Section: Diagnostic Criteriamentioning

confidence: 99%

The multidisciplinary approach in the diagnosis of idiopathic pulmonary fibrosis: a patient case-based review

Tomassetti¹,

Piciucchi

Tantalocco³

et al. 2015

Eur Respir Rev

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Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressively fibrosing interstitial pneumonia that is associated with a significantly worse prognosis than other forms of chronic interstitial pneumonia. An early and accurate diagnosis of IPF is important to enable the initiation of disease-specific therapies, which have the potential to reduce disease progression, and the avoidance of inappropriate and potentially harmful drugs. Establishing an accurate diagnosis of IPF can be challenging. Recent studies and international guidelines advocate the importance of a multidisciplinary team (MDT) in the initial diagnostic assessment of patients with suspected IPF. Typical MDT members include a pulmonologist, a radiologist and a pathologist, with further input from a thoracic surgeon, a rheumatologist, a specialist nurse and an occupational physician where appropriate. Multidisciplinary diagnosis is considered the gold standard because it can improve the accuracy of diagnosis of IPF, avoid unnecessary testing (e.g. lung biopsy), and optimise patient management. Here we highlight the strengths and limitations of the multidisciplinary approach to IPF diagnosis through MDT discussion of two patient cases. @ERSpublicationsThe strengths and limitations of IPF management by a multidisciplinary team are highlighted in two patient cases http://ow.ly/H04Xe

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“…Therefore, in an appropriate clinical setting, the presence of a UIP pattern on HRCT is sufficient to make the diagnosis of IPF. Recently, was suggested that surgical lung biopsy sampling might not be necessary also in patients with possible UIP pattern on HRCT [16]. This is a new approach with respect to 2002 recommendations [2] which stated that the histologic patterns provide the primary basis for the various categories of IIP and that a highly probable diagnosis of IPF can be made without a lung biopsy, whereas a definitive diagnosis can be established only with the aid of a surgical lung biopsy.…”

mentioning

confidence: 99%

Idiopathic interstitial pneumonias: do HRCT criteria established by ATS/ERS/JRS/ALAT in 2011 predict disease progression and prognosis?

et al. 2015

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Diagnosis of idiopathic pulmonary fibrosis with high-resolution CT in patients with little or no radiological evidence of honeycombing: secondary analysis of a randomised, controlled trial

Cited by 165 publications

References 20 publications

Clinical characteristics of idiopathic pulmonary fibrosis patients according to their smoking status

Clinical characteristics of idiopathic pulmonary fibrosis patients according to their smoking status

The multidisciplinary approach in the diagnosis of idiopathic pulmonary fibrosis: a patient case-based review

Idiopathic interstitial pneumonias: do HRCT criteria established by ATS/ERS/JRS/ALAT in 2011 predict disease progression and prognosis?

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