The chest radiograph in cystic fibrosis: a new scoring system compared with the Chrispin-Norman and Brasfield scores.

Conway, S.P.; Pond, M N; Bowler, I M; Smith, D L; Simmonds, E. John; Joanes, D N; Hambleton, G; Hiller, E; Stableforth, D E; Weller, P

doi:10.1136/thx.49.9.860

Cited by 90 publications

(65 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The severity of pulmonary disease was documented by recording the patient's best measurement of forced expiratory volume in one second (FEV1) in the previous 6 months and was compared to age/sex matched normal controls [19], to give a value for FEV1% predicted. A chest radiograph taken when the patient was stable, was assessed using the Northern scoring system [20] by a radiologist and a CF pulmonary physician who were blinded to patient details. This system scores a postero-anterior (PA) chest radiograph in quadrants out of a maximum of twenty, with higher scores representing more marked radiographical abnormalities.…”

Section: Clinical Detailsmentioning

confidence: 99%

Alpha1-antitrypsin deficiency alleles and the Taq-I G-->A allele in cystic fibrosis lung disease

Mahadeva

Westerbeek²,

Dj³

et al. 1998

Eur Respir J

View full text Add to dashboard Cite

Cystic fibrosis (CF) is characterized by progressive and ultimately fatal pulmonary disease although there are notable variations in clinical features. This heterogeneity is thought to lie outside the cystic fibrosis transmembrane regulator (CFTR) gene locus and may stem from deficiencies in the antiproteinase screen that protects the lung from proteolytic attack. One hundred and fifty seven patients were recruited from two UK CF centres. The serum concentrations of alpha1-antitrypsin, alpha1-antichymotrypsin and C-reactive protein (CRP) were determined and patients were screened for the common S and Z deficiency alleles of alpha1-antitrypsin and the G-->A mutation in the 3' noncoding region of the alpha1-antitrypsin gene (Taq-I G-->A allele). Alpha1-antitrypsin deficiency phenotypes were detected in 20 (16 MS, 1 S and 3 MZ) out of 147 unrelated tested CF patients and were, surprisingly, associated with significantly better lung function (adjusted mean forced expiratory volume in one second (FEV1) 62.5% of predicted for deficient group and 51.1% pred for normal alleles; p=0.043). The Taq-I G-->A allele was found in 21 out of 150 unrelated patients and had no significant effect on CF lung disease or on levels of alpha1-antitrypsin during the inflammatory response. We show here that, contrary to current thinking, common mutations of alpha1-antitrypsin that are associated with mild to moderate deficiency of the protein predict a subgroup of cystic fibrosis patients with less severe pulmonary disease. Moreover, the Taq-I G-->A allele has no effect on serum levels of alpha1-antitrypsin in the inflammatory response, which suggests that the previously reported association of the Taq-I G-->A allele with chronic obstructive pulmonary disease is not mediated by its effect on the serum level of alpha1-antitrypsin.

show abstract

Section: Clinical Detailsmentioning

confidence: 99%

Alpha1-antitrypsin deficiency alleles and the Taq-I G-->A allele in cystic fibrosis lung disease

Mahadeva

Westerbeek²,

Dj³

et al. 1998

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Several different scoring systems exist to assess the severity of CF lung disease on chest radiograph and to allow longitudinal follow-up [1,4]. The Chrispin-Norman chest radiograph scoring (CNS) system is widely accepted and demonstrates good reproducibility between observers [5,6].…”

mentioning

confidence: 99%

The Chrispin–Norman score in cystic fibrosis: doing away with the lateral view

Benden

Wallis²,

Owens³

et al. 2005

Eur Respir J

View full text Add to dashboard Cite

The Chrispin–Norman chest radiograph scoring (CNS) system is widely used to assess respiratory disease progression in cystic fibrosis (CF). Frontal and lateral chest radiographs were performed. The present authors developed a modified CNS, which obviates the need for the lateral film. This study compares the original and the current authors' modified scoring system.A total of 50 chest radiographs from CF children, taken between August and December 2003, were scored according to the original and modified CNS. Two observers scored all 50 chest radiographs, scoring in random order the frontal radiographs, and separately the frontal and lateral radiographs together.There was no evidence of a difference between the methods for either observer, using the Bland and Altman 95% limits of agreement as follows: observer 1 (−2.0–1.9), and observer 2 (−1.77–2.2). No evidence of a difference between the observers for either method was found, comparing the 95% limits of agreement (−5.5–5.7) with the modified CNS (−5.6–6.4).In conclusion, in terms of the final score, good agreement was found between the use of the original and modified Chrispin–Norman score. In addition, low inter-observer variability was shown for both methods. The use of the modified Chrispin–Norman chest radiograph scoring system to stage disease severity in cystic fibrosis removes the need for a lateral chest radiograph.

show abstract

“…This tomosynthesis scoring system is based on previously reported scoring systems for radiography [3][4][5][6][7][8][9][10][11][12][13] and CT [14][15][16][17][18][19][20][21][22]. Typical findings of CF pulmonary disease seen with tomosynthesis and evaluated with the scoring system are overinflation, bronchial wall thickening, parenchymal lesions, bronchiectasis and mucus plugging.…”

Section: Discussionmentioning

confidence: 99%

“…Scoring of tomosynthesis studies with radiographic CF scoring systems [3][4][5][6][7][8][9][10][11][12][13] is not optimal because additional information gained from the sectional imaging in tomosynthesis cannot be accurately incorporated into the radiography scores, with loss of important image information.…”

Section: Introductionmentioning

confidence: 99%

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

et al. 2012

View full text Add to dashboard Cite

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.Vult von Steyern, Kristina; Björkman-Burtscher, Isabella; Höglund, Peter; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats Vult von Steyern, K., Björkman-Burtscher, I., Höglund, P., Bozovic, G., Wiklund, M., & Geijer, M. (2012). Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis. European Radiology, 22(12), 2718Radiology, 22(12), -2728Radiology, 22(12), . https://doi.org/10.1007Radiology, 22(12), /s00330-012-2534 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. ABSTRACTObjectives: To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. Methods:A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients.Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Results:Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). Conclusions:The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity.

show abstract

The chest radiograph in cystic fibrosis: a new scoring system compared with the Chrispin-Norman and Brasfield scores.

Abstract: Background

Cited by 90 publications

References 10 publications

Alpha1-antitrypsin deficiency alleles and the Taq-I G-->A allele in cystic fibrosis lung disease

Alpha1-antitrypsin deficiency alleles and the Taq-I G-->A allele in cystic fibrosis lung disease

The Chrispin–Norman score in cystic fibrosis: doing away with the lateral view

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

Contact Info

Product

Resources

About