Abstract
Idiopathic pulmonary fibrosis is an interstitial lung disease of unknown etiology resulting in progressive interstitial fibrosis, with a known predilection in West Highland white terriers. In humans, computed tomography (CT) is a standard method for providing diagnostic and prognostic information, and plays a major role in the idiopathic pulmonary fibrosis staging process. Objectives of this retrospective, analytical, cross-sectional study were to establish descriptive criteria for reporting CT findings and test correlations among CT, clinical findings and survival time in West Highland white terriers with idiopathic pulmonary fibrosis. Inclusion criteria for affected West Highland white terriers were a diagnosis of idiopathic pulmonary fibrosis and available CT, bronchoscopy, bronchoalveolar lavage, echocardiography, and routine blood analysis findings. Clinically normal West Highland white terriers were recruited for the control group. Survival times were recorded for affected dogs. The main CT lung pattern and clinical data were blindly and separately graded as mild, moderate, or severe. Twenty-one West Highland white terriers with idiopathic pulmonary fibrosis and 11 control West Highland white terriers were included. The severity of pulmonary CT findings was positively correlated with severity of clinical signs (ρ = 0.48, P = 0.029) and negatively associated with survival time after diagnosis (ρ = -0.56, P = 0.025). Affected dogs had higher lung attenuation (median: -563 Hounsfield Units (HU)) than control dogs (median: -761 HU), (P < 0.001). The most common CT characteristics were ground-glass pattern (16/21) considered as a mild degree of severity, and focal reticular and mosaic ground-glass patterns (10/21) considered as a moderate degree of severity. Findings supported the use of thoracic CT as a method for characterizing idiopathic pulmonary fibrosis in West Highland white terriers and providing prognostic information for owners.
Highlights
Idiopathic pulmonary fibrosis has been described as an interstitial lung disease of unknown etiology resulting in progressive and fatal interstitial fibrosis.[1,2] Several factors are known to trigger interstitial lung diseases such as infectious agents, toxin exposure, drug reaction, immunologic condition, or neoplastic disease.[1]
The simulation estimated the area under the receiver operating characteristic curve to be 0.994 (95% confidence interval 0.978–1.00) and the parametric estimate assuming normal distributions for idiopathic pulmonary fibrosis estimated the area under the receiver operating characteristic curve to be 0.985. This is the first cross-sectional study demonstrating the correlation between the severity of the clinical signs of canine idiopathic pulmonary fibrosis and the severity of the abnormalities on computed tomography (CT)
The lung patterns on CT have been well classified depending on their specificity for usual interstitial pneumonia.[4,12,14,15]
Summary
Idiopathic pulmonary fibrosis has been described as an interstitial lung disease of unknown etiology resulting in progressive and fatal interstitial fibrosis.[1,2] Several factors are known to trigger interstitial lung diseases such as infectious agents, toxin exposure, drug reaction, immunologic condition, or neoplastic disease.[1]. Veterinary Radiology & Ultrasound published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Radiology
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