High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology

High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology

High-Resolution Computed Tomography (HRCT) plays a central role in diagnosing Idiopathic Pulmonary Fibrosis (IPF) while its role in monitoring disease progression is not clearly defined. Given the variable clinical course of the disease, we evaluated whether HRCT abnormalities predict disease behavi...

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Main Authors: Elisabetta Cocconcelli, Elisabetta Balestro, Davide Biondini, Giulio Barbiero, Roberta Polverosi, Fiorella Calabrese, Federica Pezzuto, Donato Lacedonia, Federico Rea, Marco Schiavon, Erica Bazzan, Maria Pia Foschino Barbaro, Graziella Turato, Paolo Spagnolo, Manuel G. Cosio, Marina Saetta
Format: Article
Language:English
Published: MDPI AG 2019-03-01
Series:Journal of Clinical Medicine
Subjects:
HRCT
disease progression and lung pathology
Online Access:https://www.mdpi.com/2077-0383/8/3/399
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author Elisabetta Cocconcelli
Elisabetta Balestro
Davide Biondini
Giulio Barbiero
Roberta Polverosi
Fiorella Calabrese
Federica Pezzuto
Donato Lacedonia
Federico Rea
Marco Schiavon
Erica Bazzan
Maria Pia Foschino Barbaro
Graziella Turato
Paolo Spagnolo
Manuel G. Cosio
Marina Saetta
spellingShingle Elisabetta Cocconcelli
Elisabetta Balestro
Davide Biondini
Giulio Barbiero
Roberta Polverosi
Fiorella Calabrese
Federica Pezzuto
Donato Lacedonia
Federico Rea
Marco Schiavon
Erica Bazzan
Maria Pia Foschino Barbaro
Graziella Turato
Paolo Spagnolo
Manuel G. Cosio
Marina Saetta
High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology
Journal of Clinical Medicine
HRCT
disease progression and lung pathology
author_facet Elisabetta Cocconcelli
Elisabetta Balestro
Davide Biondini
Giulio Barbiero
Roberta Polverosi
Fiorella Calabrese
Federica Pezzuto
Donato Lacedonia
Federico Rea
Marco Schiavon
Erica Bazzan
Maria Pia Foschino Barbaro
Graziella Turato
Paolo Spagnolo
Manuel G. Cosio
Marina Saetta
author_sort Elisabetta Cocconcelli
title High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology
title_short High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology
title_full High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology
title_fullStr High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology
title_full_unstemmed High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung Pathology
title_sort high-resolution computed tomography (hrct) reflects disease progression in patients with idiopathic pulmonary fibrosis (ipf): relationship with lung pathology
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2019-03-01
description High-Resolution Computed Tomography (HRCT) plays a central role in diagnosing Idiopathic Pulmonary Fibrosis (IPF) while its role in monitoring disease progression is not clearly defined. Given the variable clinical course of the disease, we evaluated whether HRCT abnormalities predict disease behavior and correlate with functional decline in untreated IPF patients. Forty-nine patients (with HRCT<sub>1</sub>) were functionally categorized as rapid or slow progressors. Twenty-one had a second HRCT<sub>2</sub>. Thirteen patients underwent lung transplantation and pathology was quantified. HRCT Alveolar (AS) and Interstitial Scores (IS) were assessed and correlated with Forced Vital Capacity (FVC) decline between HRCT<sub>1</sub> and HRCT<sub>2</sub>. At baseline, AS was greater in rapids than in slows, while IS was similar in the two groups. In the 21 subjects with HRCT<sub>2</sub>, IS increased over time in both slows and rapids, while AS increased only in rapids. The IS change from HRCT<sub>1</sub> to HRCT<sub>2</sub> normalized per month correlated with FVC decline/month in the whole population, but the change in AS did not. In the 13 patients with pathology, the number of total lymphocytes was higher in rapids than in slows and correlated with AS. Quantitative estimation of HRCTs AS and IS reflects the distinct clinical and pathological behavior of slow and rapid decliners. Furthermore, AS, which reflects the immune/inflammatory infiltrate in lung tissue, could be a useful tool to differentiate rapid from slow progressors at presentation.
topic HRCT
disease progression and lung pathology
url https://www.mdpi.com/2077-0383/8/3/399
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spelling doaj-9fdea9fb42d54406a5ab57095e6711a52020-11-24T22:28:17ZengMDPI AGJournal of Clinical Medicine2077-03832019-03-018339910.3390/jcm8030399jcm8030399High-Resolution Computed Tomography (HRCT) Reflects Disease Progression in Patients with Idiopathic Pulmonary Fibrosis (IPF): Relationship with Lung PathologyElisabetta Cocconcelli0Elisabetta Balestro1Davide Biondini2Giulio Barbiero3Roberta Polverosi4Fiorella Calabrese5Federica Pezzuto6Donato Lacedonia7Federico Rea8Marco Schiavon9Erica Bazzan10Maria Pia Foschino Barbaro11Graziella Turato12Paolo Spagnolo13Manuel G. Cosio14Marina Saetta15Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyInstitute of Radiology, Department of Medicine, University of Padova, 35128 Padova, ItalyIstituto Diagnostico Antoniano - Affidea, 35100 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Medical and Surgical Sciences, University of Foggia, Policlinico “OO. Riuniti”, 71122 Foggia, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Medical and Surgical Sciences, University of Foggia, Policlinico “OO. Riuniti”, 71122 Foggia, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, 35128 Padova, ItalyHigh-Resolution Computed Tomography (HRCT) plays a central role in diagnosing Idiopathic Pulmonary Fibrosis (IPF) while its role in monitoring disease progression is not clearly defined. Given the variable clinical course of the disease, we evaluated whether HRCT abnormalities predict disease behavior and correlate with functional decline in untreated IPF patients. Forty-nine patients (with HRCT<sub>1</sub>) were functionally categorized as rapid or slow progressors. Twenty-one had a second HRCT<sub>2</sub>. Thirteen patients underwent lung transplantation and pathology was quantified. HRCT Alveolar (AS) and Interstitial Scores (IS) were assessed and correlated with Forced Vital Capacity (FVC) decline between HRCT<sub>1</sub> and HRCT<sub>2</sub>. At baseline, AS was greater in rapids than in slows, while IS was similar in the two groups. In the 21 subjects with HRCT<sub>2</sub>, IS increased over time in both slows and rapids, while AS increased only in rapids. The IS change from HRCT<sub>1</sub> to HRCT<sub>2</sub> normalized per month correlated with FVC decline/month in the whole population, but the change in AS did not. In the 13 patients with pathology, the number of total lymphocytes was higher in rapids than in slows and correlated with AS. Quantitative estimation of HRCTs AS and IS reflects the distinct clinical and pathological behavior of slow and rapid decliners. Furthermore, AS, which reflects the immune/inflammatory infiltrate in lung tissue, could be a useful tool to differentiate rapid from slow progressors at presentation.https://www.mdpi.com/2077-0383/8/3/399HRCTdisease progression and lung pathology

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