Serial Evaluation of High-Resolution Computed Tomography Findings in Patients with Idiopathic Pulmonary Fibrosis in Usual Interstitial Pneumonia

Respiration ◽  
2002 ◽  
Vol 69 (5) ◽  
pp. 413-419 ◽  
Author(s):  
Taishi Nagao ◽  
Sonoko Nagai ◽  
Yoshihide Hiramoto ◽  
Kunio Hamada ◽  
Michio Shigematsu ◽  
...  
Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 762
Author(s):  
Elisa Baratella ◽  
Barbara Ruaro ◽  
Fabiola Giudici ◽  
Barbara Wade ◽  
Mario Santagiuliana ◽  
...  

Background. Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease (ILD). This prospective observational study aimed at the evaluation of any correlation between genetic variants associated with IPF susceptibility and high-resolution computed tomography (HRCT) patterns. It also aimed at evidencing any differences in the HRTC pattern between the familial and sporadic form at diagnosis and after two years. Methods. A total of 65 IPF patients (mean age at diagnosis 65 ± 10) were enrolled after having given written informed consent. HRCT and genetic evaluations were performed. Results. A total of 19 familial (mean age 62 ± 15) and 46 sporadic (mean age 70 ± 9) IPF patients were enrolled. A statistically significant difference was evidenced in the HRTC pattern at diagnosis between the two groups. Sporadic IPF patients had a predominantly usual interstitial pneumonia (UIP) pattern compared with those patients with familial IPF (60.0% vs. 21.1%, respectively). Moreover, familial IPF patients had more alternative diagnoses than those with sporadic IPF (31.6% vs. 2.2%, respectively). Furthermore, there was a slight increase in the typical UIP pattern in the familial IPF group at two years from diagnosis. Conclusions. Genetic factors play a pivotal role in the risk of developing IPF. However, further studies are required to clarify how these genetic factors may guide clinical treatment decisions.


2020 ◽  
Vol 14 ◽  
pp. 175346662096849
Author(s):  
Steven D. Nathan ◽  
Jean Pastre ◽  
Inga Ksovreli ◽  
Scott Barnett ◽  
Christopher King ◽  
...  

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.


2020 ◽  
Vol 34 (10) ◽  
pp. 13979-13980
Author(s):  
Wenxi Yu ◽  
Hua Zhou ◽  
Jonathan G. Goldin ◽  
Grace Hyun J. Kim

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.


2020 ◽  
Vol 35 (2) ◽  
pp. 115-122 ◽  
Author(s):  
Stefano Palmucci ◽  
Sebastiano E. Torrisi ◽  
Daniele Falsaperla ◽  
Alessandro Stefano ◽  
Alfredo G. Torcitto ◽  
...  

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