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Prognostic determinants among clinical, thin-section CT, and histopathologic findings for fibrotic idiopathic interstitial pneumonias: tertiary hospital study.
Radiology. 2008 Oct; 249(1):328-37.R

Abstract

PURPOSE

To evaluate the utility of clinical, thin-section computed tomography (CT), and histopathologic findings in predicting the prognosis of patients with usual interstitial pneumonia (UIP) or fibrotic nonspecific interstitial pneumonia (NSIP).

MATERIALS AND METHODS

The institutional review board approved this retrospective study, with waiver of informed consent. Included were 108 patients (71 men, 37 women; mean age, 61 years +/- 8 [standard deviation]) with UIP (n = 79; 60 men, 19 women; mean age, 63 years +/- 7.4) and fibrotic NSIP (n = 29; 11 men, 18 women; mean age, 57 years +/- 12.9). Patients underwent pulmonary function tests (PFTs), bronchoalveolar lavage (BAL) fluid analysis, and thin-section CT. Two chest radiologists independently assigned scores for the extent of lung abnormalities detected at CT twice at 3-month intervals. The effect of histopathologic diagnoses and clinical and thin-section CT features on survival was evaluated by using Cox regression analyses.

RESULTS

The 5-year survival rate (mean follow-up, 45 months) of patients with fibrotic NSIP was 76% in contrast to 46% for patients with UIP (P = .006). With multivariate analysis, a high fibrotic score (the extent of reticulation plus honeycombing) (hazard ratio = 1.200, P = .043) and an initial low diffusing capacity of lung for carbon monoxide (Dlco) level (hazard ratio = 0.973, P = .025) were identified as associated with increased death risk.

CONCLUSION

Patients with UIP or fibrotic NSIP who have a high fibrotic score determined at thin-section CT and a low Dlco level appear to have a high death risk.

Authors+Show Affiliations

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18682581

Citation

Shin, Kyung Min, et al. "Prognostic Determinants Among Clinical, Thin-section CT, and Histopathologic Findings for Fibrotic Idiopathic Interstitial Pneumonias: Tertiary Hospital Study." Radiology, vol. 249, no. 1, 2008, pp. 328-37.
Shin KM, Lee KS, Chung MP, et al. Prognostic determinants among clinical, thin-section CT, and histopathologic findings for fibrotic idiopathic interstitial pneumonias: tertiary hospital study. Radiology. 2008;249(1):328-37.
Shin, K. M., Lee, K. S., Chung, M. P., Han, J., Bae, Y. A., Kim, T. S., & Chung, M. J. (2008). Prognostic determinants among clinical, thin-section CT, and histopathologic findings for fibrotic idiopathic interstitial pneumonias: tertiary hospital study. Radiology, 249(1), 328-37. https://doi.org/10.1148/radiol.2483071378
Shin KM, et al. Prognostic Determinants Among Clinical, Thin-section CT, and Histopathologic Findings for Fibrotic Idiopathic Interstitial Pneumonias: Tertiary Hospital Study. Radiology. 2008;249(1):328-37. PubMed PMID: 18682581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic determinants among clinical, thin-section CT, and histopathologic findings for fibrotic idiopathic interstitial pneumonias: tertiary hospital study. AU - Shin,Kyung Min, AU - Lee,Kyung Soo, AU - Chung,Man Pyo, AU - Han,Joungho, AU - Bae,Young A, AU - Kim,Tae Sung, AU - Chung,Myung Jin, Y1 - 2008/08/05/ PY - 2008/8/7/pubmed PY - 2008/10/16/medline PY - 2008/8/7/entrez SP - 328 EP - 37 JF - Radiology JO - Radiology VL - 249 IS - 1 N2 - PURPOSE: To evaluate the utility of clinical, thin-section computed tomography (CT), and histopathologic findings in predicting the prognosis of patients with usual interstitial pneumonia (UIP) or fibrotic nonspecific interstitial pneumonia (NSIP). MATERIALS AND METHODS: The institutional review board approved this retrospective study, with waiver of informed consent. Included were 108 patients (71 men, 37 women; mean age, 61 years +/- 8 [standard deviation]) with UIP (n = 79; 60 men, 19 women; mean age, 63 years +/- 7.4) and fibrotic NSIP (n = 29; 11 men, 18 women; mean age, 57 years +/- 12.9). Patients underwent pulmonary function tests (PFTs), bronchoalveolar lavage (BAL) fluid analysis, and thin-section CT. Two chest radiologists independently assigned scores for the extent of lung abnormalities detected at CT twice at 3-month intervals. The effect of histopathologic diagnoses and clinical and thin-section CT features on survival was evaluated by using Cox regression analyses. RESULTS: The 5-year survival rate (mean follow-up, 45 months) of patients with fibrotic NSIP was 76% in contrast to 46% for patients with UIP (P = .006). With multivariate analysis, a high fibrotic score (the extent of reticulation plus honeycombing) (hazard ratio = 1.200, P = .043) and an initial low diffusing capacity of lung for carbon monoxide (Dlco) level (hazard ratio = 0.973, P = .025) were identified as associated with increased death risk. CONCLUSION: Patients with UIP or fibrotic NSIP who have a high fibrotic score determined at thin-section CT and a low Dlco level appear to have a high death risk. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/18682581/Prognostic_determinants_among_clinical_thin_section_CT_and_histopathologic_findings_for_fibrotic_idiopathic_interstitial_pneumonias:_tertiary_hospital_study_ L2 - https://pubs.rsna.org/doi/10.1148/radiol.2483071378?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -