Yeon Joo Jeong MD, Presenter: Nothing to Disclose

David Augustine Lynch MBBCh, Abstract Co-Author: Research support, Siemens AG Scientific Advisor, PAREXEL International Corporation Consultant, Boehringer Ingelheim GmbH Consultant, InterMune, Inc Consultant, Gilead Sciences, Inc Consultant, F. Hoffmann-La Roche Ltd Consultant, Veracyte, Inc Research support, Johnson & Johnson Research support, AstraZeneca PLC

Seungbaek Hong MD, Abstract Co-Author: Nothing to Disclose

Ji Young Rho, Abstract Co-Author: Nothing to Disclose

Ji Won Lee MD, Abstract Co-Author: Nothing to Disclose

To correlate CT scoring systems for pulmonary sarcoidosis with cardiopulmonary exercise testing and to evaluate which scoring system provides the most reliable information to assess disease severity and predict impairment of gas exchange during exercise.

Institutional review board approved this retrospective study and the requirement for patient informed consent was waived. All 62 patients (31 male and 31 female; mean age, 50.8 years) with sarcoidosis underwent CT, pulmonary function tests, and cardiopulmonary exercise test. Two independent observers scored CT patterns and extent according to scoring systems published by Remy-Jardin et al, Oberstein et al, and Leung et al. Weighted kappa and intraclass correlation coefficient were used to assess the reliability of CT scoring systems. Spearman’s rank correlation coefficients were calculated between CT patterns and pulmonary functional impairment parameters and multiple regression analyses were performed to evaluate which CT abnormalities were significantly associated with pulmonary functional impairment parameters.

Interobserver agreement for CT scoring was excellent or good for the Remy-Jardin scoring system whereas fair or good for the Oberstein and the Leung scoring systems. All CT abnormalities scored with the Remy-Jardin scoring system showed moderate to fair correlation with DLCO% (Spearman’s rho = -0.270~-0.426), SaO2 max (Spearman's rho = -0.265~-0.534), PaO2 max (Spearman’s rho = -0.328~-0.551), and Vd/Vt max (Spearman’s rho = 0.279~0.495). Regardless of scoring system, PaO2 max was significantly associated with the subscores of ground glass opacity, linear opacity and total CT scores. Multiple regression analyses showed that subscores of ground glass and linear opacity in the Leung scoring system and subscores of consolidation and septal and nonseptal lines and total CT scores of the Oberstein scoring system appeared to explain a significant amount of variance in functional parameters at rest and at maximal exercise.

CT findings, particularly ground glass linear opacities can explain a significant amount of variance in cardiopulmonary exercise parameters. This suggests that CT-based scoring systems are valid measures of disease severity in sarcoidosis.

Although current CT scoring systems are quite complicated and subjective, CT-based scoring systems are valid measures of disease severity in sarcoidosis.

Jeong, Y, Lynch, D, Hong, S, Rho, J, Lee, J, CT Scoring Systems in Sarcoidosis: Comparison with Cardiopulmonary Exercise Testing Parameters.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045570.html