Abstract
BackgroundHoneycombing on high-resolution computed tomography (HRCT) images is a key finding in idiopathic pulmonary fibrosis (IPF). In IPF, honeycombing area determined by quantitative CT analysis is correlated with pulmonary function test findings. We hypothesized that quantitative CT-derived honeycombing area (HA) might predict mortality in patients with IPF.Materials and methodsChest HRCT images of 52 IPF patients with definite usual interstitial pneumonia (UIP) pattern were retrospectively evaluated. Mortality data up to July 31, 2016, were recorded. Using a computer-aided system, HA and percentage of HA (%HA) were measured quantitatively. Predictors of 3-year mortality were evaluated using logistic regression models.ResultsThe median %HA, %predicted forced vital capacity (FVC) and composite physiologic index (CPI) were 3.8%, 83.6%, and 33.6, respectively. According to GAP (gender, age, and physiology) stage, 20, 14, and 5 patients were classified under stages I-II-III, respectively. Percentage of HA was significantly correlated with %FVC, CPI, and GAP stage (all, p < 0.001). In univariate analysis, %HA, %FVC, and CPI were statistically significant predictors of mortality. In multivariate analysis using the stepwise regression method, only %HA (odds ratio [OR], 1.27; p = 0.011) was a significant independent predictors of mortality. Patients with %HA ≥ 4.8% had significantly lower survival rates than those with lesser %HA (median survival time, 1.3 vs 5.0 years; log-rank test; p < 0.001).ConclusionQuantitative CT-derived HA might be an important and independent predictor of mortality in IPF patients with definite UIP pattern.
Highlights
Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic and progressive fibrosing interstitial pneumonia of unknown cause [1,2,3]
Percentage of honeycombing area (HA) was significantly correlated with %forced vital capacity (FVC), composite physiologic index (CPI), and GAP stage
The extent of honeycombing area on high-resolution computed tomography (HRCT) images is an independent predictor of mortality in idiopathic pulmonary fibrosis (IPF) [1, 4, 5]
Summary
Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic and progressive fibrosing interstitial pneumonia of unknown cause [1,2,3]. Honeycombing is one of the key findings on high-resolution computed tomography (HRCT) images in IPF with definite usual interstitial pneumonia (UIP) pattern. The extent of honeycombing area on HRCT images is an independent predictor of mortality in IPF [1, 4, 5]. There are some reports about computer-based quantitative CT analyses [11,12,13,14,15,16,17,18] These methods may be the useful and reliable for objective assessment of HRCT findings including honeycombing. Honeycombing on high-resolution computed tomography (HRCT) images is a key finding in idiopathic pulmonary fibrosis (IPF). In IPF, honeycombing area determined by quantitative CT analysis is correlated with pulmonary function test findings. We hypothesized that quantitative CT-derived honeycombing area (HA) might predict mortality in patients with IPF
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