Visually stratified CT honeycombing as a survival predictor in combined pulmonary fibrosis and emphysema

Kim, Yong Seek; Jin, Gong Yong; Chae, Kum Ju; Han, Young Min; Chon, Su Bin; Kwon, Keun Sang; Choi, Hye Mi

doi:10.1259/bjr.20150545

Cited by 14 publications

(10 citation statements)

References 25 publications

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“…The presence of honeycombing has been previously reported as predictive of worse outcome in interstitial lung disease [13][14][15]. Those with 'possible' or 'inconsistent' UIP CT pattern with minimal honeycombing have also been reported to have improved survival.…”

Section: Discussionmentioning

confidence: 99%

Evolution of diagnostic UIP computed tomography patterns in idiopathic pulmonary fibrosis: Disease spectrum and implications for survival

Giacomi

White

Cox

et al. 2018

Respiratory Medicine

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Section: Discussionmentioning

confidence: 99%

Evolution of diagnostic UIP computed tomography patterns in idiopathic pulmonary fibrosis: Disease spectrum and implications for survival

Giacomi

White

Cox

et al. 2018

Respiratory Medicine

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“…In cluster 2, the degree of honeycombing, reticulation, and emphysema was not significantly different from cluster 3, whereas the extent of GGO was higher. In many studies, honeycombing and reticulation are defined as a CT fibrosis score, and prognosis is worse with an increasing extent of honeycombing and reticulation [4, 10, 20]. Our study found that the extent of GGO in patients with severe fibrosis may affect prognosis.…”

Section: Discussionmentioning

confidence: 55%

“…Disease extent on CT has been used as a prognostic determinant of IPF. Visually stratifying the extent of honeycombing on CT may help predict prognosis in IPF with emphysema [20]. However, visual scoring of IPF by radiologists shows high interobserver variability and is somewhat subjective.…”

Section: Discussionmentioning

confidence: 99%

Predicting clinical outcome with phenotypic clusters using quantitative CT fibrosis and emphysema features in patients with idiopathic pulmonary fibrosis

et al. 2019

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Background The clinical course of IPF varies. This study sought to identify phenotyping with quantitative computed tomography (CT) fibrosis and emphysema features using a cluster analysis and to assess prognostic impact among identified clusters in patient with idiopathic pulmonary fibrosis (IPF). Furthermore, we evaluated the impact of fibrosis and emphysema on lung function with development of a descriptive formula. Methods This retrospective study included 205 patients with IPF. A texture-based automated system was used to quantify areas of normal, emphysema, ground-glass opacity, reticulation, consolidation, and honeycombing. Emphysema index was obtained by calculating the percentage of low attenuation area lower than -950HU. We used quantitative CT features and clinical features for clusters and assessed the association with prognosis. A formula was derived using fibrotic score and emphysema index on quantitative CT. Results Three clusters were identified in IPF patients using a quantitative CT score and clinical values. Prognosis was better in cluster1, with a low extent of fibrosis and emphysema with high forced vital capacity (FVC) than cluster2 and cluster3 with higher fibrotic score and emphysema ( p = 0.046, and p = 0.026). In the developed formula [1.5670—fibrotic score(%)*0.04737—emphysema index*0.00304], a score greater ≥ 0 indicates coexisting of pulmonary fibrosis and emphysema at a significant extent despite of normal spirometric result. Conclusions Cluster analysis identified distinct phenotypes, which predicted prognosis of clinical outcome. Formula using quantitative CT values is useful to assess extent of pulmonary fibrosis and emphysema with normal lung function in patients with IPF.

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“…9 Kim et al also showed that low DL CO (HR: 0.97, P = 0.017) was independently associated with increased mortality in CPFE patients with honeycombing on CT (HR: 1.95, P = 0.018), but FVC was not. 23 In a study by Kishaba et al, FEV 1 /FVC > 1.2 was a prognostic factor for mortality (HR: 1.93, P = 0.005) in CPFE with finger clubbing (HR: 2.26, P = 0.015). 24 Our study showed that, in IPF-only patients, FVC decline was a significant predictor of mortality, as were FVC and DL CO .…”

Section: Discussionmentioning

confidence: 94%

Effects of emphysema on physiological and prognostic characteristics of lung function in idiopathic pulmonary fibrosis

et al. 2018

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Visually stratified CT honeycombing as a survival predictor in combined pulmonary fibrosis and emphysema

Abstract: Visual estimation of honeycombing extent on CT can help in the prediction of prognosis in CPFE.

Cited by 14 publications

References 25 publications

Evolution of diagnostic UIP computed tomography patterns in idiopathic pulmonary fibrosis: Disease spectrum and implications for survival

Evolution of diagnostic UIP computed tomography patterns in idiopathic pulmonary fibrosis: Disease spectrum and implications for survival

Predicting clinical outcome with phenotypic clusters using quantitative CT fibrosis and emphysema features in patients with idiopathic pulmonary fibrosis

Effects of emphysema on physiological and prognostic characteristics of lung function in idiopathic pulmonary fibrosis

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