Pallavi Bedi1, James D Chalmers2, Pieter C Goeminne3, Cindy Mai4, Pira Saravanamuthu5, Prasad Palani Velu5, Manjit K Cartlidge6, Michael R Loebinger7, Joe Jacob7, Faisal Kamal7, Nicola Schembri2, Stefano Aliberti8, Uta Hill9, Mike Harrison9, Christopher Johnson9, Nicholas Screaton9, Charles Haworth9, Eva Polverino10, Edmundo Rosales10, Antoni Torres10, Michael N Benegas10, Adriano G Rossi6, Dilip Patel5, Adam T Hill11. 1. MRC Center for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK. Electronic address: drpallavibedi@gmail.com. 2. School of Medicine, University of Dundee, Dundee, UK. 3. Department of Respiratory Disease, AZ Nikolaas, Sint-Niklaas, Belgium. 4. University Hospitals of Leuven, Department of Radiology, Leuven, Belgium. 5. Royal Infirmary of Edinburgh, Edinburgh, UK. 6. MRC Center for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK. 7. Royal Brompton, London, UK. 8. Department of Pathophysiology and Transplantation, University of Milan Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 9. Cambridge Center for Lung Infection, Papworth Hospital, Cambridge, UK. 10. Institut Clínic del Tòrax, Hospital Clínic de Barcelona, Barcelona, Spain. 11. MRC Center for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK; Royal Infirmary of Edinburgh, Edinburgh, UK.
Abstract
OBJECTIVES: The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. METHODS: The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. RESULTS: A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV1, sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV1, 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. CONCLUSIONS: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis.
OBJECTIVES: The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. METHODS: The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. RESULTS: A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV1, sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV1, 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. CONCLUSIONS: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis.
Authors: Katherine A Despotes; Radmila Choate; Doreen Addrizzo-Harris; Timothy R Aksamit; Alan Barker; Ashwin Basavaraj; Charles L Daley; Edward Eden; Angela DiMango; Kevin Fennelly; Julie Philley; Margaret M Johnson; Pamela J McShane; Mark L Metersky; Anne E O'Donnell; Kenneth N Olivier; Matthias A Salathe; Andreas Schmid; Byron Thomashow; Gregory Tino; Kevin L Winthrop; Michael R Knowles; Mary Leigh Anne Daniels; Peadar G Noone Journal: Chronic Obstr Pulm Dis Date: 2020-10
Authors: Diego Jose Maselli; Andrew Yen; Wei Wang; Yuka Okajima; Wojciech R Dolliver; Christina Mercugliano; Antonio Anzueto; Marcos I Restrepo; Timothy R Aksamit; Ashwin Basavaraj; Stefano Aliberti; Kendra A Young; Gregory L Kinney; J Michael Wells; Raúl San José Estépar; David A Lynch; Alejandro A Diaz Journal: Radiology Date: 2021-06-22 Impact factor: 29.146