Imaging of Pulmonary Sarcoidosis—A Review

Bailey, Georgina L.; Wells, Athol U.; Desai, Sujal R.

doi:10.3390/jcm13030822

JCM

2024

DOI: 10.3390/jcm13030822

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Imaging of Pulmonary Sarcoidosis—A Review

Georgina L. Bailey,

Athol U. Wells,

Sujal R. Desai

Abstract: Sarcoidosis is the classic multisystem granulomatous disease. First reported as a disorder of the skin, it is now clear that, in the overwhelming majority of patients with sarcoidosis, the lungs will bear the brunt of the disease. This review explores some of the key concepts in the imaging of pulmonary sarcoidosis: the wide array of typical (and some of the less common) findings on high-resolution computed tomography (HRCT) are reviewed and, with this, the concept of morphologic/HRCT phenotypes is discussed. … Show more

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Cited by 2 publications

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Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Nardone,

Minichetti,

Sauro

et al. 2024

J Med Imaging Intervent Radiol

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According to the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines, a right heart catheterization-derived mean pulmonary arterial pressure (mPAP) > 20 mmHg at rest defines pulmonary hypertension (PH). As PH can ultimately lead to death, multidisciplinary early diagnosis, proper framework, and prompt management are crucial. ESC/ERS PH classification encompasses five groups, each sharing pathogenesis, hemodynamics, and management, i.e., group I, pulmonary arterial hypertension; II, left heart disease; III, lung disease and/or hypoxia; IV, chronic thromboembolic PH; and V, with unclear and/or multifactorial mechanisms. Chest CT is pivotal in PH grouping, comprehensively evaluating the lung, heart, pulmonary vessels, and mediastinum. In this review, we synoptically illustrate the chest CT findings of PH and provide a CT-based logical framework suggesting a PH group hypothesis. Improving knowledge of PH CT features and their combination empowers radiologists to contribute valuably to the PH multidisciplinary clinical discussion.

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Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Nardone,

Minichetti,

Sauro

et al. 2024

J Med Imaging Intervent Radiol

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Pirfenidone in Idiopathic Pulmonary Fibrosis: Real-World Observation on Efficacy and Safety, Focus on Patients Undergoing Antithrombotic and Anticoagulant

Reccardini,

Chernovsky,

Salton

et al. 2024

Pharmaceuticals

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Idiopathic pulmonary fibrosis (IPF) is a rare and progressive interstitial lung disease characterized by irreversible distortion of lung architecture and subsequent loss of pulmonary function. Pirfenidone is an antifibrotic agent associated with increased progression-free survival and overall survival rates, but it carries multiple side effects. The aim of the study was to examine the efficacy and safety profile of pirfenidone in a real-life context, with a focus on the concomitant use of antithrombotic and/or anticoagulant treatments. The clinical and functional data (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], diffusing lung capacity for carbon monoxide [DLCO], and 6 min walking test distance [6MWD]) of all IPF patients treated with pirfenidone and referred to our two centers between 2019 and 2022 were retrospectively analyzed at baseline, 6 and 12 months after the start of treatment. A total of 55 IPF subjects undergoing pirfenidone treatment were included in the analysis (45.5% females, median [IQR] age at disease onset 68.0 [10.0] years, median [IQR] age at baseline 69.0 [10.8] years). Compared to baseline, at 12 months, FVC (86.0% vs. 80.0%; p = 0.023) and DLCO (44.0% vs. 40.0%; p = 0.002) were significantly reduced, while FEV1 (p = 0.304) and 6MWD (p = 0.276) remained stable; no significant change was recorded at 6 months. Most of the reported adverse events were mild or moderate. Gastrointestinal intolerance (9.1%) was the main cause of treatment discontinuation. A total of 5% of patients reported at least one minor bleeding event, although all episodes occurred in those receiving concomitant antithrombotic or anticoagulant. Overall, this real-life experience confirms the efficacy and safety profile of pirfenidone in the case of the concomitant use of antithrombotic and/or anticoagulant drugs.

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Imaging of Pulmonary Sarcoidosis—A Review

Cited by 2 publications

References 124 publications

Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Pirfenidone in Idiopathic Pulmonary Fibrosis: Real-World Observation on Efficacy and Safety, Focus on Patients Undergoing Antithrombotic and Anticoagulant

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