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.
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: William D Travis; Ulrich Costabel; David M Hansell; Talmadge E King; David A Lynch; Andrew G Nicholson; Christopher J Ryerson; Jay H Ryu; Moisés Selman; Athol U Wells; Jurgen Behr; Demosthenes Bouros; Kevin K Brown; Thomas V Colby; Harold R Collard; Carlos Robalo Cordeiro; Vincent Cottin; Bruno Crestani; Marjolein Drent; Rosalind F Dudden; Jim Egan; Kevin Flaherty; Cory Hogaboam; Yoshikazu Inoue; Takeshi Johkoh; Dong Soon Kim; Masanori Kitaichi; James Loyd; Fernando J Martinez; Jeffrey Myers; Shandra Protzko; Ganesh Raghu; Luca Richeldi; Nicola Sverzellati; Jeffrey Swigris; Dominique Valeyre Journal: Am J Respir Crit Care Med Date: 2013-09-15 Impact factor: 21.405
Authors: Kevin R Flaherty; Kevin K Brown; Athol U Wells; Emmanuelle Clerisme-Beaty; Harold R Collard; Vincent Cottin; Anand Devaraj; Yoshikazu Inoue; Florence Le Maulf; Luca Richeldi; Hendrik Schmidt; Simon Walsh; William Mezzanotte; Rozsa Schlenker-Herceg Journal: BMJ Open Respir Res Date: 2017-09-17