High-resolution CT scoring system-based grading scale predicts the clinical outcomes in patients with idiopathic pulmonary fibrosis

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• 作者：Keishi Oda (1)
  Hiroshi Ishimoto (1)
  Kazuhiro Yatera (1)
  Keisuke Naito (1)
  Takaaki Ogoshi (1)
  Kei Yamasaki (1)
  Tomotoshi Imanaga (2)
  Toru Tsuda (3)
  Hiroyuki Nakao (4)
  Toshinori Kawanami (1)
  Hiroshi Mukae (1)
  
• 关键词：HRCT fibrosis score ; UIP pattern ; Spirometry ; Monitoring methods ; Idiopathic pulmonary fibrosis
• 刊名：Respiratory Research
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：15
• 期：1
• 全文大小：1,295 KB
• 作者单位：Keishi Oda (1)
  Hiroshi Ishimoto (1)
  Kazuhiro Yatera (1)
  Keisuke Naito (1)
  Takaaki Ogoshi (1)
  Kei Yamasaki (1)
  Tomotoshi Imanaga (2)
  Toru Tsuda (3)
  Hiroyuki Nakao (4)
  Toshinori Kawanami (1)
  Hiroshi Mukae (1)
  
  1. Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan
  2. Department of Respiratory Medicine, Steel Memorial Yawata Hospital, 1-1-1, Harunomachi, Yahatahigashiku, Kitakyushu City, Fukuoka, 805-8508, Japan
  3. Department of Medicine, Kirigaoka Tsuda Hospital, 3-9-20 Kirigaoka, Kokuraminamiku, Kitakyushu City, Fukuoka, 802-0052, Japan
  4. Department of Epidemiology, National Institute of Public Health, Wako, Saitama, Japan, 2-3-6 Minami, Wako-shi, Saitama, 351-0197, Japan
  
• ISSN：1465-9921

文摘

Background The 2011 idiopathic pulmonary fibrosis (IPF) guidelines are based on the diagnosis of IPF using only high-resolution computed tomography (HRCT). However, few studies have thus far reviewed the usefulness of the HRCT scoring system based on the grading scale provided in the guidelines. We retrospectively studied 98 patients with respect to assess the prognostic value of changes in HRCT findings using a new HRCT scoring system based on the grading scale published in the guidelines. Methods Consecutive patients with IPF who were diagnosed using HRCT alone between January 2008 and January 2012 were evaluated. HRCT examinations and pulmonary function tests were performed at six-month intervals for the first year after diagnosis. The HRCT findings were evaluated using the new HRCT scoring system (HRCT fibrosis score) over time. The findings and survival rates were analyzed using a Kaplan-Meier analysis. Results The HRCT fibrosis scores at six and 12 months after diagnosis were significantly increased compared to those observed at the initial diagnosis (p-lt;-.001). The patients with an elevated HRCT fibrosis score at six months based on a receiver operating characteristic (ROC) curves analysis had a poor prognosis (log-rank, hazard ratio [HR] 2.435, 95% CI 1.196-4.962; p--.0142). Furthermore, among the patients without marked changes in %FVC, those with an elevated score above the cut-off value had a poor prognosis (HR 2.192, 95% CI 1.003-4.791; p--.0491). Conclusions Our data demonstrate that the HRCT scoring system based on the grading scale is useful for predicting the clinical outcomes of IPF and identifying patients with an adverse prognosis when used in combination with spirometry.