Kyung-Hyun Do MD, Presenter: Nothing to Disclose

Jin Seong Lee MD, Abstract Co-Author: Nothing to Disclose

Joon Beom Seo MD, Abstract Co-Author: Nothing to Disclose

Dong Soon Kim, Abstract Co-Author: Nothing to Disclose

Masanori Kitaichi, Abstract Co-Author: Nothing to Disclose

Thomas V Colby MD, Abstract Co-Author: Nothing to Disclose

Jae Woo Song MD, Abstract Co-Author: Nothing to Disclose

Koun-Sik Song MD, Abstract Co-Author: Nothing to Disclose

Tae-Hwan Lim MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Most patients with biopsy-proven nonspecific interstitial pneumonia (NSIP) show improvement with treatment, but some patients do not respond to treatment and progress to pulmonary fibrosis. We hypothesized that initial high-resolution computed tomography (CT) findings would predict the physiologic improvement after treatment, and the changes of CT findings correlate with physiologic improvements. The authors investigated the prognostic implication of high-resolution CT features in this condition.

We reviewed the high-resolution CT findings of 22 patients diagnosed with NSIP by histopathology, who had follow-up with pulmonary physiologic tests for a median of 25 weeks with treatment. We scored the presence and extent of each pretreatment CT finding (ground-glass opacity, consolidation, reticular opacity, and honeycombing). Physiologic parameters such as total lung capacity (TLC), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume at one second (FEV1), and diffusing capacity (DLCO) were measured at pre- and post-treatment. Follow-up pulmonary physiologic tests were used to determine whether the disease had regressed or progressed in response to treatment. We compared the extent of CT findings and changes in pulmonary physiologic parameters, and the extent of CT findings of the responder group with that of the non-responder.

The extent of consolidation at initial CT correlated with changes in VC (r=0.566, p=0.004). In addition, the extent of consolidation at initial CT was greater in response group (n=8, 3.75±2.91%) than in non-response group (n=14, 1.31±2.55%)(p=0.035). Changes in the extent of consolidation correlated with changes in TLC, VC, FVC, and FEV1 (r=0.608, 0.724, 0.617, 0.715, p<0.05). Changes in extent of reticular opacity correlated with changes in TLC and VC (r=0.497, 0.381, p<0.05).

In patients with NSIP, the extent of consolidation in initial CT scan correlate with the improvement of pulmonary physiology after treatment, and could be used as an indicator of responsiveness to treatment. The consolidation decreased on follow-up high-resolution CT, and the extent of decrease correlated significantly with physiologic improvement.

Do, K, Lee, J, Seo, J, Kim, D, Kitaichi, M, Colby, T, Song, J, Song, K, Lim, T, et al, , Nonspecific Interstitial Pneumonia: High-Resolution CT Features Predicting Treatment Responsiveness.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412848.html