David Augustine Lynch MD, Presenter: Nothing to Disclose

William D Travis, Abstract Co-Author: Nothing to Disclose

Jeffrey R. Galvin MD, Abstract Co-Author: Nothing to Disclose

David M Hansell, Abstract Co-Author: Nothing to Disclose

Talmadge E King MD, Abstract Co-Author: Nothing to Disclose

Gary Hunninghake, Abstract Co-Author: Nothing to Disclose

Takashi Koyama MD, Abstract Co-Author: Nothing to Disclose

Nestor Luiz Muller MD, Abstract Co-Author: Nothing to Disclose

Ella Annabelle Kazerooni MD, Abstract Co-Author: Nothing to Disclose

Thomas Edward Hartman MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To identify the CT features of NSIP in a multi-center study.

One hundred and ninety-three cases were enrolled in an international multi-center study of the clinical, imaging, and pathologic features of NSIP, sponsored by the American Thoracic Society. A consensus panel of clinicians, radiologist and pathologists classified the cases into four groups: definite NSIP, probable NSIP, possible NSIP, definitely not NSIP. Separately and without knowledge of the consensus diagnosis, all cases were reviewed and scored independently by three radiologists. Imaging features were systematically recorded using a standardized scoresheet.

Of the 193 cases evaluated by the consensus group, 26 had images technically inadequate for detailed imaging review, leaving 167 patients who underwent imaging review. Of these, 17 (10%) were scored as definitely NSIP, with a further 44 (23%) having probable NSIP. Among the 61 patients scored as definite or probable NSIP, 56 (92%) had lower lung predominant abnormality, with lower lobe volume loss present in 47 (77%). A ground glass/reticular pattern was present in 53 (87%) cases. Traction bronchiectasis was present in 50 (82%), and consolidation was present in 8 (13%). Honeycombing was present in 3 (5%). Thirty-eight patients (62%) had an imaging pattern characterized by at least three of the following features: ground glass/reticular pattern, traction bronchiectasis, lower lobe volume loss, and subpleural sparing.

NSIP is characterized on imaging by a basal predominant ground glass/reticular pattern, with traction bronchiectasis and lower lobe volume loss. Honeycombing is rare.

Lynch, D, Travis, W, Galvin, J, Hansell, D, King, T, Hunninghake, G, Koyama, T, Muller, N, Kazerooni, E, Hartman, T, et al, , Nonspecific Interstitial Pneumonia (NSIP): CT Appearances.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412556.html