Imaging in non-cystic fibrosis bronchiectasis and current limitations

Abstract

Non-cystic fibrosis bronchiectasis represents a heterogenous spectrum of disorders characterised by an abnormal and permanent dilatation of the bronchial tree associated with respiratory symptoms. To date, diagnosis relies on computed tomography (CT) evidence of dilated airways. Nevertheless, definite radiological criteria and standardised CT protocols are still to be defined. Although largely used, current radiological scoring systems have shown substantial drawbacks, mostly failing to correlate morphological abnormalities with clinical and prognostic data. In limited cases, bronchiectasis morphology and distribution, along with associated CT features, enable radiologists to confidently suggest an underlying cause. Quantitative imaging analyses have shown a potential to overcome the limitations of the current radiological criteria, but their application is still limited to a research setting. In the present review, we discuss the role of imaging and its current limitations in non-cystic fibrosis bronchiectasis. The potential of automatic quantitative approaches and artificial intelligence in such a context will be also mentioned.

The effect of a training webinar on decreasing inter-observer variability in making a radiologic diagnosis of bronchiectasis

“…The utility of consensus panels may offer unique opportunities evaluating the approach to reading CT scans for bronchiectasis in the future. Other methods have been proposed such as quantitative CT imaging [ 26 , 27 ]. However, many patients with bronchiectasis live in resource-poor regions of the world and the technology remains imperfect, often limiting quantitative CT imaging to research settings.…”

Correlating Reiff scores with clinical, functional, and prognostic factors: characterizing noncystic fibrosis bronchiectasis severity: validation from a nationwide multicenter study in Taiwan

“…The Reiff score, based on subjective evaluation of bronchiectasis features, fails to capture the diversity of the disease. It has the potential to assign high scores to patients with localized but severe abnormalities while neglecting those with widespread yet less pronounced structural problems [ 9 ]. While BRICS considers clinic prognostic factors, it lacks a relationship between specific CT features and disease activity degree, a vital factor in treatment decisions [ 7 ].…”

Inhaled Antibiotics in Non-cystic Fibrosis Bronchiectasis (NCFB): A Systematic Review of Efficacy and Limitations in Adult Patients

“…Bronchiectasis refers to a heterogeneous group of respiratory diseases that are characterized by permanent abnormal dilation of the bronchi that leads to chronic productive cough, recurrent infections, and dyspnea [1,2]. It is classified into two broad categories: cystic fibrosis (CF) and non-cystic fibrosis (NCF), based on etiology.…”

“…Failure to identify the underlying cause is a frequent concern in many patients. In recent years, an increase in incidence has been reported in the NCF variety due to physicians' awareness and the easy availability of radiological imaging [2]. Chest x-ray and high-resolution computerized tomography scan are the imaging modalities of choice in such patients.…”