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Computed tomography findings in pathological usual interstitial pneumonia: relationship to survival.
Am J Respir Crit Care Med. 2008 Feb 15; 177(4):433-9.AJ

Abstract

RATIONALE

Patients with a clinicopathological diagnosis of idiopathic pulmonary fibrosis (IPF) may have typical findings of usual interstitial pneumonia (UIP) on computed tomography (CT) or nonspecific or atypical findings, including those often seen in nonspecific interstitial pneumonia.

OBJECTIVES

The aims of this study were to revisit the high-resolution CT findings of IPF and to clarify the correlation between the CT findings and mortality.

METHODS

The study included 98 patients with a histologic diagnosis of UIP and a clinical diagnosis of IPF. Two observers evaluated the CT findings independently and classified each case into one of the following three categories: (1) definite UIP, (2) consistent with UIP, or (3) suggestive of alternative diagnosis. The correlation between the CT categories and mortality was evaluated using the Kaplan-Meier method and the log-rank test, as well as Cox proportional hazards regression models.

MEASUREMENTS AND MAIN RESULTS

Thirty-three of the 98 CT scans were classified as definite UIP, 36 as consistent with UIP, 29 as suggestive of an alternative diagnosis. The mean survival was 45.7, 57.9, and 76.9 months, respectively. There was no significant difference in survival among the three categories (all P > 0.05). Traction bronchiectasis and fibrosis scores were significant predictors of outcome (hazard ratios: 1.30 and 1.10, respectively; 95% confidence intervals: 1.18-14.2 and 1.03-1.19, respectively).

CONCLUSIONS

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.

Authors+Show Affiliations

Department of Radiology, Osaka University Graduate School of Medical, 2-2 Yamadaoka, Suita, Osaka, 565-0825, Japan. h-sumikawa@radiol.med.osaka-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17975197

Citation

Sumikawa, Hiromitsu, et al. "Computed Tomography Findings in Pathological Usual Interstitial Pneumonia: Relationship to Survival." American Journal of Respiratory and Critical Care Medicine, vol. 177, no. 4, 2008, pp. 433-9.
Sumikawa H, Johkoh T, Colby TV, et al. Computed tomography findings in pathological usual interstitial pneumonia: relationship to survival. Am J Respir Crit Care Med. 2008;177(4):433-9.
Sumikawa, H., Johkoh, T., Colby, T. V., Ichikado, K., Suga, M., Taniguchi, H., Kondoh, Y., Ogura, T., Arakawa, H., Fujimoto, K., Inoue, A., Mihara, N., Honda, O., Tomiyama, N., Nakamura, H., & Müller, N. L. (2008). Computed tomography findings in pathological usual interstitial pneumonia: relationship to survival. American Journal of Respiratory and Critical Care Medicine, 177(4), 433-9.
Sumikawa H, et al. Computed Tomography Findings in Pathological Usual Interstitial Pneumonia: Relationship to Survival. Am J Respir Crit Care Med. 2008 Feb 15;177(4):433-9. PubMed PMID: 17975197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Computed tomography findings in pathological usual interstitial pneumonia: relationship to survival. AU - Sumikawa,Hiromitsu, AU - Johkoh,Takeshi, AU - Colby,Thomas V, AU - Ichikado,Kazuya, AU - Suga,Moritaka, AU - Taniguchi,Hiroyuki, AU - Kondoh,Yasuhiro, AU - Ogura,Takashi, AU - Arakawa,Hiroaki, AU - Fujimoto,Kiminori, AU - Inoue,Atsuo, AU - Mihara,Naoki, AU - Honda,Osamu, AU - Tomiyama,Noriyuki, AU - Nakamura,Hironobu, AU - Müller,Nestor L, Y1 - 2007/11/01/ PY - 2007/11/3/pubmed PY - 2008/3/7/medline PY - 2007/11/3/entrez SP - 433 EP - 9 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 177 IS - 4 N2 - RATIONALE: Patients with a clinicopathological diagnosis of idiopathic pulmonary fibrosis (IPF) may have typical findings of usual interstitial pneumonia (UIP) on computed tomography (CT) or nonspecific or atypical findings, including those often seen in nonspecific interstitial pneumonia. OBJECTIVES: The aims of this study were to revisit the high-resolution CT findings of IPF and to clarify the correlation between the CT findings and mortality. METHODS: The study included 98 patients with a histologic diagnosis of UIP and a clinical diagnosis of IPF. Two observers evaluated the CT findings independently and classified each case into one of the following three categories: (1) definite UIP, (2) consistent with UIP, or (3) suggestive of alternative diagnosis. The correlation between the CT categories and mortality was evaluated using the Kaplan-Meier method and the log-rank test, as well as Cox proportional hazards regression models. MEASUREMENTS AND MAIN RESULTS: Thirty-three of the 98 CT scans were classified as definite UIP, 36 as consistent with UIP, 29 as suggestive of an alternative diagnosis. The mean survival was 45.7, 57.9, and 76.9 months, respectively. There was no significant difference in survival among the three categories (all P > 0.05). Traction bronchiectasis and fibrosis scores were significant predictors of outcome (hazard ratios: 1.30 and 1.10, respectively; 95% confidence intervals: 1.18-14.2 and 1.03-1.19, respectively). CONCLUSIONS: 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. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/17975197/Computed_tomography_findings_in_pathological_usual_interstitial_pneumonia:_relationship_to_survival_ L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.200611-1696OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -