Long-term follow-up high-resolution CT findings in non-specific interstitial pneumonia.

Abstract

BACKGROUND:

The aims of this study were to retrospectively assess the change in findings on follow-up CT scans of patients with non-specific interstitial pneumonia (NSIP; median, 72 months; range, 3-216 months) and to clarify the correlation between the baseline CT findings and mortality.

METHODS:

The study included 50 patients with a histologic diagnosis of NSIP. Two observers evaluated the high-resolution CT (HRCT) findings independently and classified each case into one of the following three categories: (1) compatible with NSIP, (2) compatible with UIP or (3) suggestive of alternative diagnosis. The correlation between the HRCT findings and mortality was evaluated using the Kaplan-Meier method and the log-rank test, as well as Cox proportional hazards regression models.

RESULTS:

Ground-glass opacity and consolidation decreased, whereas coarseness of fibrosis and traction bronchiectasis increased on the follow-up HRCT scans, however, in 78% of cases the overall extent of parenchymal abnormalities had no change or decreased. Patients with HRCT diagnosed compatible with NSIP had a longer survival than those with HRCT findings more compatible UIP or an alternative diagnosis. On multivariate analysis, the coarseness of fibrosis alone was associated with prognosis (HR: 1.480; 95% CIs 1.100 to 1.990).

CONCLUSIONS:

The HRCT patterns seen in patients with a histopathologic diagnosis of NSIP progress in a variable manner. Overall disease extent may decrease over time in some, while fibrosis may progress in others. The initial HRCT diagnosis may impact survival in this group of patients.

• Authors: Masanori Akira, Yoshikazu Inoue, Toru Arai, Tomohisa Okuma, Yutaka Kawata
• Journal: Thorax (Thorax) Vol. 66 Issue 1 Pg. 61-5 (Jan 2011) ISSN: 1468-3296 [Electronic] England
• PMID: 21071764 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Disease Progression
• Epidemiologic Methods
• Female
• Humans
• Lung Diseases, Interstitial (diagnostic imaging, pathology)
• Male
• Middle Aged
• Observer Variation
• Prognosis
• Tomography, X-Ray Computed (methods)
• Young Adult