High-Resolution CT Findings in Fibrotic Idiopathic Interstitial Pneumonias With Little Honeycombing: Serial Changes and Prognostic Implications

Lee, Ho Yun; Lee, Kyung Soo; Jeong, Yeon Joo; Hwang, Jung Hwa; Kim, Hyo Jin; Chung, Man Pyo; Han, Joungho

doi:10.2214/ajr.11.8192

Cited by 93 publications

(71 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering fibrotic idiopathic interstitial pneumonias (IIPs) with little honeycombing, the results from two recent publications have provided guidance on differentiating UIP from NSIP without biopsy [8,9]. In particular, UIP has been shown to be associated with increasing age, increasing reticulation and decreasing ground-glass opacities.…”

Section: Differential Diagnosis Of Atypical Ipf On Hrctmentioning

confidence: 99%

See 1 more Smart Citation

Imaging: how to recognise idiopathic pulmonary fibrosis

Devaraj¹

2014

Eur Respir Rev

View full text Add to dashboard Cite

It is well known that high-resolution computed tomography (HRCT) is an essential component of the diagnostic pathway in idiopathic pulmonary fibrosis (IPF). Honeycombing, a common feature of IPF seen on HRCT, is crucial for an accurate diagnosis. Unfortunately, identification of honeycombing is not always straightforward, and there is some disagreement regarding its imaging features. It can be difficult to distinguish honeycombing from traction bronchiectasis and emphysema, although several imaging characteristics can be helpful. Recently, there has been an interest in expanding the use of HRCT beyond diagnosis for disease monitoring and prognostication, and several studies have provided valuable contributions in this regard. Traction bronchiectasis and the extent of fibrosis, for example, have been reported to be powerful prognostic predictors for mortality. Finally, considering the difficulties in diagnosis of ''possible usual interstitial pneumonia'', clinicians should always be aware that clinical factors must be considered together with HRCT in order to reach an accurate diagnosis and provide appropriate treatment. @ERSpublications In addition to clinical factors, HRCT features are increasingly useful for both diagnosis and prognosis of IPF http://ow.ly/vAJJ8

show abstract

Section: Differential Diagnosis Of Atypical Ipf On Hrctmentioning

confidence: 99%

“…LEE et al [9] used HRCT to monitor disease progression in 154 patients (UIP: n5101; NSIP: n553) with fibrotic IIPs with little honeycombing and a histological diagnosis of a fibrotic IIP (,5% honeycombing on HRCT). The patients were followed clinically for at least 2 years.…”

Section: Using Hrct To Prognosticate Ipf and Monitor Disease Progressionmentioning

confidence: 99%

Imaging: how to recognise idiopathic pulmonary fibrosis

Devaraj¹

2014

Eur Respir Rev

View full text Add to dashboard Cite

show abstract

“…Though several past studies suggested that wider honeycombing is one of the HRCT findings suggesting the diagnosis of IPF [18], [19] and recent IPF guidelines might set a high value on HRCT patterns to diagnose IPF, honeycombing on HRCT may not be essential for diagnosing IPF.…”

Section: Discussionmentioning

confidence: 99%

Clinical course and changes in high-resolution computed tomography findings in patients with idiopathic pulmonary fibrosis without honeycombing

Yamauchi

Bando

Baba

et al. 2015

1.5 Diffuse Parenchymal Lung Disease

View full text Add to dashboard Cite

Some patients with idiopathic pulmonary fibrosis (IPF) do not have honeycombing on highresolution computed tomography (HRCT) at their initial evaluation. The clinical course and sequential changes in HRCT findings in these patients are not fully understood. We reviewed the cases of 43 patients with IPF without honeycombing on initial HRCT from institutions throughout Japan. All patients were diagnosed with IPF based on a surgical lung biopsy. Multidisciplinary discussions were held five times between 2011 and 2014, to exclude alternative etiologies. We evaluated the sequential changes in HRCT findings in 30 patients with IPF. We classified these 30 patients into three groups based on their HRCT patterns and clarified the clinical characteristics and prognosis among the groups. The patterns of all 30 patients on initial HRCT corresponded to a possible usual interstitial pneumonia (UIP) pattern which was described in the 2011 International Statement. On long-term follow-up (71.0±38.7 standard deviation [SD] months), honeycombing was seen in 16 patients (53%, the HoneyCo group); traction bronchiectasis or cysts without honeycombing was observed in 12 patients (40%, the NoHoneyCo group), and two patients showed no interval change (7%, the NoChange group) on HRCT. The mean survival periods of the HoneyCo and NoHoneyCo groups were 67.1 and 61.2 months, respectively (p = 0.76). There are some patients with IPF whose conditions chronically progress without PLOS ONE |

show abstract

“…typical UIP pattern at imaging) is indeed associated with an increased mortality rate as compared to patients with pathologic UIP but no honeycombing on HRCT [97,98]. The development in the extent of honeycombing on serial computed tomography is associated with shorter survival [99]. We suspect that ''waiting'' for honeycombing to diagnose IPF when early nonspecific ILD is present at HRCT may be deleterious to patients who could have undergone a diagnostic lung biopsy earlier with limited risk and be treated before lung function is too impaired.…”

Section: Honeymoon Before Honeycombingmentioning

confidence: 98%

Neglected evidence in idiopathic pulmonary fibrosis: from history to earlier diagnosis

Cordier¹,

Cottin²

2013

Eur Respir J

View full text Add to dashboard Cite

This perspective highlights some evidence that has hitherto been neglected, especially because it may not have been sufficiently explicated in the clinical respiratory medicine literature. Idiopathic pulmonary fibrosis (IPF) has appeared only in the second half of the 20th century and, like lung cancer and chronic obstructive pulmonary disease, may be a direct consequence of the cigarette smoking epidemic. It is a disease of lung ageing, with most affected patients being .70 years of age. The relationship between lung ageing and pulmonary fibrosis is further illustrated in the bleomycin mouse model, in which older males develop more fibrosis than young female mice.Earlier diagnosis of IPF is a prerequisite for significant progress to be made in the long-term outcome and prognosis. We consider that only two different yet complementary and realistic approaches could lead to earlier diagnosis of IPF and possibly to allowing more efficient disease management: 1) investigating any patients with early Velcro crackles at lung auscultation through proactive education of, and commitment from, primary care physicians; and 2) using current large-scale lung cancer screening strategies with lowdose high-resolution computed tomography in smokers for the detection of subclinical interstitial lung disease and especially early IPF. @ERSpublications Only two approaches could lead to earlier diagnosis of IPF and more efficient disease management

show abstract

High-Resolution CT Findings in Fibrotic Idiopathic Interstitial Pneumonias With Little Honeycombing: Serial Changes and Prognostic Implications

Cited by 93 publications

References 20 publications

Imaging: how to recognise idiopathic pulmonary fibrosis

Imaging: how to recognise idiopathic pulmonary fibrosis

Clinical course and changes in high-resolution computed tomography findings in patients with idiopathic pulmonary fibrosis without honeycombing

Neglected evidence in idiopathic pulmonary fibrosis: from history to earlier diagnosis

Contact Info

Product

Resources

About