Document Detail

High-resolution computed tomography in idiopathic pulmonary fibrosis: diagnosis and prognosis.
MedLine Citation:
PMID:  15894598     Owner:  NLM     Status:  MEDLINE    
RATIONALE: High-resolution computed tomography (HRCT) is an integral aspect of the evaluation of patients with suspected idiopathic pulmonary fibrosis (IPF). However, few studies have evaluated its use in a large cohort. OBJECTIVES: To describe HRCT features in patients with mild to moderate IPF, compare diagnostic evaluations by a radiology core (three thoracic radiologists) with those by study-site radiologists, correlate baseline clinical and physiologic variables with HRCT findings, and evaluate their association with mortality. METHODS: We assessed HRCT scans from patients with IPF (n = 315) enrolled in a randomized controlled study evaluating IFN-gamma1b. MEASUREMENTS AND MAIN RESULTS: There was concordance between study-site and core radiologists regarding the diagnosis of IPF in 86% of cases. Diffusing capacity of carbon monoxide (DLCO) was the physiologic characteristic most highly correlated with HRCT findings. Multivariate analysis identified three independent predictors of mortality: a higher extent of fibrosis score increased the risk of death (p < 0.0001), whereas a higher percent-predicted DLCO (p = 0.004) and treatment assignment to IFN-gamma1b rather than placebo (p = 0.04) reduced the risk of death. CONCLUSIONS: A study-site diagnosis of IPF on HRCT was regularly confirmed by core radiologists. Extent of reticulation and honeycombing on HRCT is an important independent predictor of mortality in patients with IPF.
David A Lynch; J David Godwin; Sharon Safrin; Karen M Starko; Phil Hormel; Kevin K Brown; Ganesh Raghu; Talmadge E King; Williamson Z Bradford; David A Schwartz; W Richard Webb;
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-05-13
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  172     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-05     Completed Date:  2005-10-27     Revised Date:  2010-02-12    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  488-93     Citation Subset:  AIM; IM    
Department of Radiology, and Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Box A030, Room 2233 Denver, CO 80262, USA.
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MeSH Terms
Interferon-gamma, Recombinant / therapeutic use
Lung / radiography
Middle Aged
Multivariate Analysis
Pulmonary Diffusing Capacity
Pulmonary Fibrosis / drug therapy,  mortality,  radiography*
Risk Factors
Tomography, X-Ray Computed / methods*
Reg. No./Substance:
0/Interferon-gamma, Recombinant

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