scholarly journals Nintedanib in progressive interstitial lung diseases: data from the whole INBUILD trial

2021 ◽  
pp. 2004538
Author(s):  
Kevin R. Flaherty ◽  
Athol U. Wells ◽  
Vincent Cottin ◽  
Anand Devaraj ◽  
Yoshikazu Inoue ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Practice ◽  
High Resolution ◽  
Lung Diseases ◽  
Vital Capacity ◽  
Usual Interstitial Pneumonia ◽  
Interstitial Lung Diseases ◽  
Primary Analysis ◽  
High Resolution Computed Tomography ◽  
To Receive

The primary analysis of the INBUILD trial showed that in subjects with progressive fibrosing interstitial lung diseases (ILDs), nintedanib slowed the decline in forced vital capacity (FVC) over 52 weeks. We report the effects of nintedanib on ILD progression over the whole trial.Subjects with fibrosing ILDs other than idiopathic pulmonary fibrosis, who had ILD progression within the 24 months before screening despite management deemed appropriate in clinical practice, were randomised to receive nintedanib or placebo. Subjects continued on blinded randomised treatment until all subjects had completed the trial. Over the whole trial, mean (sd) exposure to trial medication was 15.6 (7.2) and 16.8 (5.8) months in the nintedanib and placebo groups, respectively.In the nintedanib (n=332) and placebo (n=331) groups, respectively, the proportions of subjects who had ILD progression (absolute decline in FVC ≥10% predicted) or died were 40.4% and 54.7% in the overall population (HR 0.66 [95% CI: 0.53, 0.83]; p=0.0003), and 43.7% and 55.8% among subjects with a usual interstitial pneumonia (UIP)-like fibrotic pattern on high-resolution computed tomography (HRCT) (HR 0.69 [0.53, 0.91]; p=0.009). In the nintedanib and placebo groups, respectively, the proportions who had an acute exacerbation of ILD or died were 13.9% and 19.6% in the overall population (HR 0.67 [95% CI: 0.46, 0.98]; p=0.04), and 15.0% and 22.8% among subjects with a UIP-like fibrotic pattern on HRCT (HR 0.62 [0.39, 0.97]; p=0.03).Based on data from the whole INBUILD trial, nintedanib reduced the risk of events indicating ILD progression.

scholarly journals Tissue Continues to Be the Issue: Role of Histopathology in the Context of Recent Updates in the Radiologic Classification of Interstitial Lung Diseases

2019 ◽  
Vol 143 (1) ◽  
pp. 30-33
Author(s):  
Kirtee Raparia ◽  
Rishi Raj
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Clinical Decision Making ◽  
Usual Interstitial Pneumonia ◽  
White Paper ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Histopathologic Confirmation

Context.— High-resolution computed tomography (HRCT) imaging has an increasingly important role in clinical decision-making in patients with interstitial lung diseases. The recent Fleischner Society white paper on the diagnostic criteria for idiopathic pulmonary fibrosis highlights the advances in our understanding of HRCT imaging in interstitial lung diseases. Objective.— To discuss the evidence and recommendations outlined in the white paper as it pertains to the radiologic diagnosis of interstitial lung disease, specifically highlighting the current limitations of HRCT in confidently predicting histopathologic findings. Data Sources.— The recent Fleischner Society white paper and other studies pertaining to the role of HRCT in predicting histopathology in interstitial lung diseases are reviewed. Conclusions.— High-resolution computed tomography is highly predictive of a usual interstitial pneumonia (UIP) pattern on histopathology when the HRCT shows a typical UIP pattern on a “confident” read by the radiologist. A probable UIP pattern is also very predictive of a UIP pattern on histopathology, and histopathologic confirmation is not needed for most patients demonstrating this pattern in the appropriate clinical setting. A UIP pattern may be seen in a substantial proportion of patients with an “indeterminate UIP” pattern on HRCT and in many patients for whom the HRCT suggests an alternative diagnosis; histopathologic confirmation should be considered in patients demonstrating these patterns whenever feasible.

scholarly journals The Role of Transthoracic Ultrasound in the Study of Interstitial Lung Diseases: High-Resolution Computed Tomography Versus Ultrasound Patterns: Our Preliminary Experience

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 439
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Angelamaria Giardinelli ◽  
Carla Maria Irene Quarato ◽  
Ennio Vincenzo Sassani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Pleural Line ◽  
Complementary Role ◽  
Number Of Patients ◽  
Significant Difference ◽  
Transthoracic Ultrasound

Transthoracic ultrasound (TUS) is a readily available imaging tool that can provide a quick real-time evaluation. The aim of this preliminary study was to establish a complementary role for this imaging method in the approach of interstitial lung diseases (ILDs). TUS examination was performed in 43 consecutive patients with pulmonary fibrosis and TUS findings were compared with the corresponding high-resolution computed tomography (HRCT) scans. All patients showed a thickened hyperechoic pleural line, despite no difference between dominant HRCT patterns (ground glass, honeycombing, mixed pattern) being recorded (p > 0.05). However, pleural lines’ thickening showed a significant difference between different HRCT degree of fibrosis (p < 0.001) and a negative correlation with functional parameters. The presence of >3 B-lines and subpleural nodules was also assessed in a large number of patients, although they did not demonstrate any particular association with a specific HRCT finding or fibrotic degree. Results allow us to suggest a complementary role for TUS in facilitating an early diagnosis of ILD or helping to detect a possible disease progression or eventual complications during routine clinical practice (with pleural line measurements and subpleural nodules), although HRCT remains the gold standard in the definition of ILD pattern, disease extent and follow-up.

scholarly journals High Resolution Computed Tomography Scan Assessment of Different Interstitial Lung Diseases

2020 ◽  
Vol 7 (22) ◽  
pp. 1062-1067
Author(s):  
Mrinal Kanti Ghosh ◽  
Priyadarshini Sur ◽  
Mustafijur Rahaman ◽  
Soumitra Kumar Ghosh ◽  
Raman Sau ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Computed Tomography Scan ◽  
High Resolution Computed Tomography ◽  
Tomography Scan

scholarly journals High-resolution computed tomography as a non-invasive imaging biomarker for interstitial lung diseases: a tertiary center study

2021 ◽  
Vol 8 (2) ◽  
pp. 207
Author(s):  
Krishna Pratap Singh Senger ◽  
Ankita Singh
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Pneumonia ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Imaging Biomarker ◽  
Histopathological Diagnosis ◽  
High Resolution Computed Tomography ◽  
Non Invasive ◽  
Tertiary Center

Background: Interstitial lung diseases (ILD) are a heterogeneous group of non-neoplastic disorders resulting from damage to the lung parenchyma by varying patterns of inflammation and fibrosis. With high-resolution computed tomography (HRCT) the pattern of lung damage can be mapped accurately which may help to identify specific ILD.Methods: 65 diagnosed cases of ILD by HRCT who were admitted to a tertiary care chest hospital, formed the study group. All these patients also underwent histopathological confirmation as per hospital protocol. The study was done over a period from August 2016 to July 2019. Clinical details, chest x-ray, HRCT and histopathological data was collected and analysed using 2x2 table for detecting sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV).Results: For diagnosing ILD like acute interstitial pneumonia (AIP), LIP and RB ILD the HRCT fared equally well in diagnostic utility as compared to histopathological examination. But in certain conditions like non-specific interstitial pneumonia (NSIP) the HRCT performed poorly in terms of PPV as compared to gold standard histopathology. In Bronchiolitis obliterans organizing pneumonia (BOOP) and usual interstitial pneumonia (UIP) again the HRCT performed fairly well as compared to gold standard.Conclusions: HRCT shows good correlation with histopathological diagnosis in identifying a various subtype of ILD and may thus serve a useful non-invasive, imaging biomarker not only for diagnosing a particular ILD but for prognostication and response to treatment.

Computed tomography in the differential diagnosis of interstitial lung diseases in occupational health

2020 ◽  
pp. 572-572
Author(s):  
T. B. Burmistrova
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Pulmonary Diseases ◽  
High Resolution Computed Tomography ◽  
Fibrosing Alveolitis ◽  
Additional Method ◽  
Hypersensitive Pneumonitis

High-resolution computed tomography made it possible to assess changes in the lungs from the effects of industrial aerosols in the development of interstitial pulmonary diseases of professional and non-professional Genesis in 342 patients: pneumoconiosis, hypersensitive pneumonitis, allergic and fibrosing alveolitis, sarcoidosis, pulmonary tuberculosis. High-resolution computed tomography was an additional method in the diagnosis of various forms of lung diseases.

scholarly journals Pattern classification of interstitial lung disease in high resolution clinical datasets: A systematic review

2018 ◽  
Vol 7 (2.7) ◽  
pp. 114
Author(s):  
S Ummay Atiya ◽  
N V.K Ramesh
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Different Types ◽  
Deep Convolution Neural Network ◽  
Paper Review ◽  
The Many

Automated tissues characterization helps to diagnosis the various diseases including Interstitial lung diseases (ILD). The various features and the several classifiers are used in categorize the different layers depend on the pattern presented in the image. The different types of diseases may occur in the lungs and some of the diseases happen to leave the scars. These scars can be found in the High Resolution Computed Tomography (HRCT) and have different pattern. The different diseases cause the different pattern in the images and these is classified using the efficient classifier that helps to diagnosis the diseases. In this paper, review for the many researches regarding to the classification of the different pattern from the Computed Tomography (CT) images is presented. The evaluation of the efficiency of the methods in terms of classifier and database used for the research is made. The Deep Convolution Neural Network (CNN) provides the promising classifier efficiency compared to the other researches for different pattern. In general, there are five types of pattern is classified: Healthy, ground glass, honeycomb, Fibrosis, and emphysema.

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