Diffuse Pulmonary Ossification on High-Resolution Computed Tomography in Idiopathic Pulmonary Fibrosis, Systemic Sclerosis-Related Interstitial Lung Disease, and Chronic Hypersensitivity Pneumonitis: A Comparative Study

2020 ◽  
Vol 44 (5) ◽  
pp. 667-672
Author(s):  
Lara Walkoff ◽  
Anuj S. Dixit ◽  
Jay H. Ryu ◽  
Jonathan H. Chung ◽  
Christian W. Cox
Keyword(s):  
Computed Tomography ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Comparative Study ◽  
Hypersensitivity Pneumonitis ◽  
High Resolution Computed Tomography ◽  
Chronic Hypersensitivity Pneumonitis

scholarly journals HRCT evaluation of patients with interstitial lung disease: comparison of the 2018 and 2011 diagnostic guidelines

2020 ◽  
Vol 14 ◽  
pp. 175346662096849
Author(s):  
Steven D. Nathan ◽  
Jean Pastre ◽  
Inga Ksovreli ◽  
Scott Barnett ◽  
Christopher King ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Disease ◽  
Usual Interstitial Pneumonia ◽  
Kappa Statistic ◽  
High Resolution Computed Tomography ◽  
New Guidelines

Background and aims: Chest high-resolution computed tomography (HRCT) is the central diagnostic tool in discerning idiopathic pulmonary fibrosis (IPF) from other interstitial lung disease (ILDs). In 2018, new guidelines were published and the nomenclature for HRCT interpretation was changed. We sought to evaluate how clinicians’ interpretation would change based on reading HRCTs under the framework of the old versus new categorization. Materials and methods: We collated HRCTs from 50 random cases evaluated in the Inova Fairfax ILD clinic. Six ILD experts were provided the deidentified HRCTs. They were all instructed to independently provide two reads of each HRCT, based on the old and the new guidelines. Results: The kappa statistic for concordance for HRCT reads under old guidelines was 0.5, while for the new guidelines it was 0.38. Under the framework of the old guidelines, there were 22 HRCTs with unanimous consensus reads, while only 15 with the new guidelines. There were 12 HRCTs read unanimously as usual interstitial pneumonia (UIP) pattern based on both the old and the new guidelines. Ten HRCTs were read as a possible UIP pattern based on the old guidelines and were classified in nine cases as probable UIP and one indeterminate based on the new guidelines. Of the 28 inconsistent UIP HRCTs (old guidelines), 25 were read as alternative diagnosis suggested, two were read as indeterminate and one as probable UIP. Conclusion: Implementation of the new guidelines to categorize HRCTs in ILD patients appears to be associated with greater inter-interpreter variability. How or whether new guidelines improve the care and management of ILD patients remains unclear. The reviews of this paper are available via the supplemental material section.

scholarly journals AB0605 CLINICAL PROFILE AND CHEST HIGH-RESOLUTION COMPUTED TOMOGRAPHY (HRCT) FINDINGS IN PATIENTS WITH CONNECTIVE TISSUE DISEASES AND INTERSTITIAL LUNG DISEASE: EXPERIENCE OF A SINGLE REFERENCE RHEUMATOLOGY CENTER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1598.2-1599
Author(s):  
I. Rusu ◽  
L. Muntean ◽  
M. M. Tamas ◽  
I. Felea ◽  
L. Damian ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Connective Tissue Diseases ◽  
High Resolution Computed Tomography ◽  
Hrct Patterns

Background:Interstitial lung disease (ILD) is a common manifestation of connective tissue diseases (CTDs), and is associated with significant morbidity and mortality. Chest high-resolution computed tomography (HRCT) play an important role in the diagnosis of ILD and may provide prognostic information.Objectives:We aimed to characterize the clinical profile and chest HRCT abnormalities and patterns of patients diagnosed with CTDs and ILD.Methods:In this retrospective, observational study we included 80 consecutive patients with CTDs and ILD referred to a tertiary rheumatology center between 2015 and 2019. From hospital charts we collected clinical data, immunologic profile, chest HRCT findings. HRCT patterns were defined according to new international recommendations.Results:Out of 80 patients, 64 (80%) were women, with a mean age of 55 years old. The most common CTD associated with ILD was systemic sclerosis (38.8%), followed by polymyositis (22.5%) and rheumatoid arthritis (18.8%). The majority of patients had dyspnea on exertion (71.3%), bibasilar inspiratory crackles were present in 56.3% patients and 10% had clubbing fingers. Antinuclear antibodies (ANA) were present in 78.8% patients, and the most frequently detected autoantibodies against extractable nuclear antigen were anti-Scl 70 (28.8%), followed by anti-SSA (anti-Ro, 17.5%), anti-Ro52 (11.3%) and anti-Jo (7.5%). Intravenous cyclophosphamide therapy for 6-12 months was used in 35% of patients, while 5% of patients were treated with mycophenolate mofetil.The most frequent HRCT abnormalities were reticular abnormalities and ground glass opacity. Non-specific interstitial pneumonia (NSIP) was identified in 46.3% CTDs patients. A pattern suggestive of usual interstitial pneumonia (UIP) was present in 32.5% patients, mainly in patients with systemic sclerosis. In 21.3% patients the HRCT showed reticulo-nodular pattern, micronodules and other abnormalities, not diagnostic for UIP or NSIP pattern.Conclusion:Nonspecific interstitial pneumonia (NSIP) is the most common HRCT pattern associated with CTDs. Further prospective longitudinal studies are needed in order to determine the clinical and prognostic significance of various HRCT patterns encountered in CTD-associated ILD and for better patient management.References:[1]Ohno Y, Koyama H, Yoshikaua T, Seki S. State-of-the-Art Imaging of the Lung for Connective Tissue Disease (CTD). Curr Rheumatol Rep. 2015;17(12):69.[2]Walsh SLF, Devaraj A, Enghelmeyer JI, Kishi K, Silva RS, Patel N, et al. Role of imaging in progressive-fibrosing interstitial lung diseases. Eur Respir Rev. 2018;27(150)Disclosure of Interests:None declared

scholarly journals Domain Knowledge-Assisted Automatic Diagnosis of Idiopathic Pulmonary Fibrosis (IPF) Using High Resolution Computed Tomography (HRCT) (Student Abstract)

2020 ◽  
Vol 34 (10) ◽  
pp. 13979-13980
Author(s):  
Wenxi Yu ◽  
Hua Zhou ◽  
Jonathan G. Goldin ◽  
Grace Hyun J. Kim
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Optimal Design ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Domain Knowledge ◽  
Population Level ◽  
Design Criterion ◽  
High Resolution Computed Tomography ◽  
Ct Slices

Domain knowledge acquired from pilot studies is important for medical diagnosis. This paper leverages the population-level domain knowledge based on the D-optimal design criterion to judiciously select CT slices that are meaningful for the disease diagnosis task. As an illustrative example, the diagnosis of idiopathic pulmonary fibrosis (IPF) among interstitial lung disease (ILD) patients is used for this work. IPF diagnosis is complicated and is subject to inter-observer variability. We aim to construct a time/memory-efficient IPF diagnosis model using high resolution computed tomography (HRCT) with domain knowledge-assisted data dimension reduction methods. Four two-dimensional convolutional neural network (2D-CNN) architectures (MobileNet, VGG16, ResNet, and DenseNet) are implemented for an automatic diagnosis of IPF among ILD patients. Axial lung CT images are acquired from five multi-center clinical trials, which sum up to 330 IPF patients and 650 non-IPF ILD patients. Model performance is evaluated using five-fold cross-validation. Depending on the model setup, MobileNet achieved satisfactory results with overall sensitivity, specificity, and accuracy greater than 90%. Further evaluation of independent datasets is underway. Based on our knowledge, this is the first work that (1) uses population-level domain knowledge with optimal design criterion in selecting CT slices and (2) focuses on patient-level IPF diagnosis.

Assessment of Lung Cancer Development in Idiopathic Pulmonary Fibrosis Patients Using Quantitative High-Resolution Computed Tomography

2020 ◽  
Vol 35 (2) ◽  
pp. 115-122 ◽  
Author(s):  
Stefano Palmucci ◽  
Sebastiano E. Torrisi ◽  
Daniele Falsaperla ◽  
Alessandro Stefano ◽  
Alfredo G. Torcitto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
High Resolution ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cancer Development ◽  
High Resolution Computed Tomography

High-Resolution Computed Tomography in Idiopathic Pulmonary Fibrosis

2005 ◽  
Vol 172 (4) ◽  
pp. 488-493 ◽  
Author(s):  
David A. Lynch ◽  
J. David Godwin ◽  
Sharon Safrin ◽  
Karen M. Starko ◽  
Phil Hormel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
High Resolution Computed Tomography

scholarly journals Comparative analysis of density histograms and visual scores in incremental and volumetric high-resolution computed tomography of the chest in idiopathic pulmonary fibrosis patients

2020 ◽  
Author(s):  
Gaetano Rea ◽  
Marina De Martino ◽  
Annalisa Capaccio ◽  
Pasquale Dolce ◽  
Tullio Valente ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Ct Scans ◽  
High Resolution Computed Tomography ◽  
Disease Extent ◽  
Single Breath ◽  
Volumetric Ct

Abstract Background Volumetric high-resolution computed tomography (HRCT) of the chest has recently replaced incremental CT in the diagnostic workup of idiopathic pulmonary fibrosis (IPF). Concomitantly, visual and quantitative scores have been proposed for disease extent assessment to ameliorate disease management. Purpose To compare the performance of density histograms (mean lung attenuation, skewness, and kurtosis) and visual scores, along with lung function correlations, in IPF patients submitted to incremental or volumetric thorax HRCT. Material and methods Clinical data and CT scans of 89 newly diagnosed and therapy-naive IPF patients were retrospectively evaluated. Results Forty-six incremental and 43 volumetric CT scans were reviewed. No differences of density histograms and visual scores estimates were found by comparing two HRCT techniques, with an optimal inter-operator agreement (concordance correlation coefficient >0.90 in all instances). Single-breath diffusing lung capacity for carbon monoxide (DLCOsb) was inversely related with the Best score (r = −00.416; p = 0.014), the Kazerooni fibrosis extent (r = −0.481; p = 0.004) and the mean lung attenuation (r = −0.382; p = 0.026), while a positive correlation was observed with skewness (r = 0.583; p = 0.001) and kurtosis (r = 0.543; p = 0.001) in the incremental HRCT sub-group. Similarly, in the volumetric CT sub-cohort, DLCOsb was significantly associated with skewness (r = 0.581; p = 0.007) and kurtosis (r = 0.549; p = 0.018). Correlations with visual scores were not confirmed. Forced vital capacity significantly related to all density indices independently on HRCT technique. Conclusions Density histograms and visual scores similarly perform in incremental and volumetric HRCT. Density quantification displays an optimal reproducibility and proves to be superior to visual scoring as more strongly correlated with lung function.

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