Bronchocele density in cystic fibrosis as an indicator of allergic broncho-pulmonary aspergillosis: A preliminary study

Occelli, A.; Soize, Sébastien; Ranc, Caroline; Giovannini‐Chami, Lisa; Bailly, Carole; Leloutre, B; Boyer, C.; Baqué-Juston, Marie

doi:10.1016/j.ejrad.2017.05.047

Cited by 13 publications

(9 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HAM has been described extensively in patients without CF and consistently demonstrated to be highly specific (100%), if not pathognomonic of ABPA [5,[7][8][9][10][11][12][13][14][15][16][17][18]. However, the relative contribution of HAM as compared to other conventional CT signs such as central bronchiectasis, mucus plugs and lung consolidation/atelectasis remained unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, to what extent HAM may have similar diagnostic performances in CF and non-CF populations still remains unknown. Preliminary results have been reported by Occelli and colleagues and, according to their study, a CT attenuation threshold of N36 HU was proposed to get a sensitivity of 100% [11]. Nevertheless, the study involved only 5 CF patients with ABPA and the specificity of the radiological sign was not assessed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CT evaluation of hyperattenuating mucus to diagnose allergic bronchopulmonary aspergillosis in the special condition of cystic fibrosis

Refait

Macey

Bui

et al. 2019

Journal of Cystic Fibrosis

View full text Add to dashboard Cite

Background: Mucus plugging (MP), central bronchiectasis (CB), and consolidation/atelectasia (CA) are conventional CT signs to diagnose allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF). Hyperattenuating mucus (HAM) has recently been described and may improve diagnostic accuracy. The goal of our study was to compare HAM versus conventional CT signs to diagnose ABPA in CF. Secondary objectives were to determine the optimal threshold of HAM quantitatively and to assess the diagnostic value of HAM using chest radiograph (CXR). Methods: The study was retrospective and included 137 patients with CF, aged N6-year-old. The presence of HAM, CB, MP and CA were determined by two radiologists in consensus. HAM was quantified using an absolute mean density value (AMD) and a ratio between mucus and paraspinal muscle (DRM). Sensitivity (Se), Specificity (Sp) and Youden's J-index were calculated. The Cystic Fibrosis Conference Consensus criteria were chosen as Gold Standard.Results: 23 out of 137 CF patients had ABPA. Using CT, the most sensitive structural alteration was MP (Se = 91%), followed by CB (Se = 87%) and CA (Se = 70%) whereas specificities were 28%, 19% and 58%, respectively. Conversely, HAM had the highest specificity (Sp = 100%) whereas Se was 69%. HAM had the highest Youden's J-index (p b 0.001) Quantitative optimal thresholds were AMD N 78 HU (Se/Sp = 71%/98%) and DRM N 1.3 (Se/Sp = 82%/97%). HAM was unseen using CXR (Se = 0%). Conclusion: HAM is the most specific CT biomarker of ABPA in CF, with good sensitivity. Our study suggests that characterization of mucus density may improve the accuracy of imaging criteria to diagnose ABPA early.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CT evaluation of hyperattenuating mucus to diagnose allergic bronchopulmonary aspergillosis in the special condition of cystic fibrosis

Refait

Macey

Bui

et al. 2019

Journal of Cystic Fibrosis

View full text Add to dashboard Cite

show abstract

“…Na TC, a hipoatenuação do parênquima pulmonar distal à alteração, principalmente nos casos de atresia brônquica devida à redução da ventilação e perfusão, e o aumento da atenuação do conteúdo da broncocele, que pode ser um indicativo de aspergilose broncopulmonar alérgica, podem estar associados. (9)…”

Section: Broncocele Ou Broncocelo (Pt)unclassified

Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal

et al. 2021

View full text Add to dashboard Cite

Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.

show abstract

“…We believe our findings are important, although limited by the small numbers, as the knowledge that even treated ABPA is associated with more advanced SLD may help guide management decisions. Our study group was, per local protocol, treated solely with oral steroids, while patients from both the Occelli and Dournes studies were treated with a combination of steroid and itraconazole 7,21 . It is not possible, from the published data of these two previous studies, to compare steroid treatment protocols nor to assess the effect of itraconazole on reported changes in HAM and IMIS.…”

Section: Discussionmentioning

confidence: 99%

Structural lung disease following allergic bronchopulmonary aspergillosis complicating pediatric cystic fibrosis

McCashney

Robinson

2021

Pediatric Pulmonology

View full text Add to dashboard Cite

Background: Allergic bronchopulmonary aspergillosis (ABPA) complicating cystic fibrosis (CF) is frequently associated with significant structural lung damage as assessed by computed tomography (CT) scanning.Methods: Using a validated CF scoring system (structural lung disease [SLD] score) we examined the degree of structural lung disease in a group of 25 children with CF who had received steroid therapy for ABPA (CF-ABPA) and compared our findings to a matched group of CF patients without ABPA (CF-CON) using both cross-section and longitudinal analysis. Further, we examined the structure-function correlation between CT findings and lung function.Results: Mean SLD score (expressed as a percentage of maximal score) was significantly higher (worse) in the CF-ABPA group than the CF-CON group (29.3% CF-ABPA vs. 18.7% CF-CON p < .05). CF-ABPA patients showed significantly greater rate of development of structural lung disease over time than CF-CON patients (6.8% per year vs 1.4% p < .01). We found no correlation between lung function and the degree of structural lung disease.Conclusions: ABPA in children with CF is associated with significantly more structural lung disease than that found in children with CF without ABPA. Despite interventive steroid therapy lung disease progresses more rapidly in those patients with ABPA and CF than control patients with CF.

show abstract

Bronchocele density in cystic fibrosis as an indicator of allergic broncho-pulmonary aspergillosis: A preliminary study

Cited by 13 publications

References 24 publications

CT evaluation of hyperattenuating mucus to diagnose allergic bronchopulmonary aspergillosis in the special condition of cystic fibrosis

CT evaluation of hyperattenuating mucus to diagnose allergic bronchopulmonary aspergillosis in the special condition of cystic fibrosis

Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal

Structural lung disease following allergic bronchopulmonary aspergillosis complicating pediatric cystic fibrosis

Contact Info

Product

Resources

About