Idiopathic interstitial pneumonias: do HRCT criteria established by ATS/ERS/JRS/ALAT in 2011 predict disease progression and prognosis?

Romei, Chiara; Tavanti, Laura; Sbragia, P; Liperi, Annalisa De; Carrozzi, Laura; Aquilini, Ferruccio; Palla, Antonio; Falaschi, Fabio

doi:10.1007/s11547-015-0526-0

Cited by 28 publications

(22 citation statements)

References 31 publications

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“…In unselected patients with fibrotic IIP, a definite UIP HRCT pattern has been associated with significantly worse survival compared to possible or inconsistent with UIP patterns 6,7 . In contrast, a difference in survival by overall HRCT pattern has not been consistently observed in patients with IPF 4,9,10 .…”

Section: Discussionmentioning

confidence: 93%

“…If radiologic honeycombing is the defining feature of a phenotype with poor outcomes, the higher prevalence of honeycombing in Arcadu and colleague’s possible UIP group may obscure survival differences when comparing to definite UIP. Of note, the handling of lung transplantation, an important event competing with death in this population, is not specifically mentioned in several reports 6,7,9 , or was handled via censoring 11 . We utilized death or lung transplant as the primary endpoint, making direct comparison with these studies difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Knowledge of the HRCT pattern may add relevant prognostic information. Among patients with idiopathic interstitial pneumonias (including some with IPF), those with a UIP pattern on HRCT have shorter survival compared to those with alternative HRCT patterns 6,7 . Evaluation of variably-defined HRCT patterns as predictors of survival in IPF cohorts have not replicated these findings 4,8–11 .…”

Section: Introductionmentioning

confidence: 99%

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Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Salisbury

Tolle

Xia

et al. 2017

Respiratory Medicine

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Background Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing lung disease of unknown etiology. Inter-society consensus guidelines on IPF diagnosis and management outline radiologic patterns including definite usual interstitial pneumonia (UIP), possible UIP, and inconsistent with UIP. We evaluate these diagnostic categories as prognostic markers among patients with IPF. Methods Included subjects had biopsy-proven UIP, a multidisciplinary team diagnosis of IPF, and a baseline high-resolution computed tomography (HRCT). Thoracic radiologists assigned the radiologic pattern and documented the presence and extent of specific radiologic findings. The outcome of interest was lung transplant-free survival. Results IPF patients with a possible UIP pattern on HRCT had significantly longer Kaplan-Meier event-free survival compared to those with definite UIP pattern (5.21 and 3.57 years, respectively, p=0.002). In a multivariable Cox proportional hazards model adjusted for baseline age, gender, %-predicted FVC, and %-predicted DLCO via the GAP Stage, extent of fibrosis (via the traction bronchiectasis score) and ever-smoker status, possible UIP pattern on HRCT (versus definite UIP) was associated with reduced hazard of death or lung transplant (HR=0.42, CI 95% 0.23–0.78, p=0.006). Conclusions Radiologic diagnosis categories outlined by inter-society consensus guidelines is a widely-reported and potentially useful prognostic marker in IPF patients, with possible UIP pattern on HRCT associated with a favorable prognosis compared to definite UIP pattern, after adjusting for relevant covariates.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Salisbury

Tolle

Xia

et al. 2017

Respiratory Medicine

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“…In this regard, there is a paucity of research in IPF. In one study by ROMEI et al [65] it was shown that baseline honeycombing >25%, fibrosis score >30% and traction bronchiectasis in all four lobes were indicators of poor outcome.…”

Section: Radiological Markers Of Disease Severitymentioning

confidence: 99%

Evaluating disease severity in idiopathic pulmonary fibrosis

et al. 2017

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Accurate assessment of idiopathic pulmonary fibrosis (IPF) disease severity is integral to the care provided to patients with IPF. However, to date, there are no generally accepted or validated staging systems. There is an abundance of data on using information acquired from physiological, radiological and pathological parameters, in isolation or in combination, to assess disease severity in IPF. Recently, there has been interest in using serum biomarkers and computed tomography-derived quantitative lung fibrosis measures to stage disease severity in IPF. This review will focus on the suggested methods for staging IPF, at baseline and on serial assessment, their strengths and limitations, as well as future developments.

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“…Also composite parameters such as the gender-age-physiology (GAP) index and the longitudinal GAP index may help to predict mortality in patients suffering from IPF [13][14][15] . Furthermore, computed tomography (CT) assessment of fibrosis extent, honeycombing pattern, and traction bronchiectasis are regarded as potential predictors of survival [16][17][18] . Moreover, several biomarkers (e.g.…”

mentioning

confidence: 99%

Spontaneous Pneumomediastinum as a Potential Predictor of Mortality in Patients with Idiopathic Pulmonary Fibrosis

Colombi¹,

Ehlers-Tenenbaum²,

Palmowski³

et al. 2016

Respiration

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control group included 36 IPF patients (28 males; median age: 69 years; VC% at baseline: 57%). In a multivariate Cox regression analysis, PM was a significant predictor of mortality [hazard ratio (HR): 3.0; p = 0.032]. Considering only patients experiencing PM at the time of IPF diagnosis (n = 4), PM was a strongly significant predictor of mortality in multivariate analysis (HR: 6.4; p = 0.007). Conclusions: Spontaneous PM is a rare but serious complication in patients with IPF and may be considered as a potential predictor of mortality.

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Idiopathic interstitial pneumonias: do HRCT criteria established by ATS/ERS/JRS/ALAT in 2011 predict disease progression and prognosis?

Abstract: HRCT classification based on 2011 guidelines showed high accuracy in stratifying fibrotic changes because in our study UIP, possible UIP and inconsistent with UIP pattern seem to be correlated with different disease progression and mortality rate.

Cited by 28 publications

References 31 publications

Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Evaluating disease severity in idiopathic pulmonary fibrosis

Spontaneous Pneumomediastinum as a Potential Predictor of Mortality in Patients with Idiopathic Pulmonary Fibrosis

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