The Quantitative CT assessment in predicting mortality in patients with Combined Pulmonary Fibrosis and Emphysema and Idiopathic Pulmonary Fibrosis Quantitative CT in combined pulmonary fibrosis and emphysema

Main Article Content

Fatma Üçsular
Gülistan Karadeniz
Gülru Polat
Enver Yalnız
Aysu Ayrancı
Akin Çinkooğlu
Recep Savaş
Hatice Solmaz
Filiz Güldaval
Melih Büyükşirin

Keywords

Combined pulmonary fibrosis and emphysema . idiopathic pulmonary fibrosis . emphysema . quantitative computerized tomography . pulmonary function test

Abstract

Aim: We aimed to evaluate the quantitative CT analysis of patients with CPFE in comparison with IPF and emphysema. Methods: Patients with CPFE(n:36), IPF(n:38) and emphysema(n:32) were retrospectively included in the study with the approval of the ethics committee. Results: There was a positive correlation between total lung volume and FVC%, TLCO% and 6 MWT, and negative correlation between mMRC and mortality. Negative correlation was found between right, left lung density and FVC%, TLCO% and 6 MWT, and positive correlation between mortality. Also, total lung volume, right and left lung densities were significant in predicting mortality and cut-off values ​​are ≤3831,> -778 and> -775, respectively(p = 0.040, 0.020, 0.013). Conclusion: Quantitative CT are guiding in predicting mortality of the disease.

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References

1. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK et al. An of ficial ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011; 183: 788–824.
2. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2015;(January). www.goldcopd.org
3. Alilović M, Peroš-Golubićić T, Tekavec Trkanjec J, Hećimović A, Smojver-Ježek S. Combined pulmonary fibrosis and emphysema syndrome [Article in Croatian]. LijecVjesn 2015; 137: 22–26.
4. Jankowich MD, Rounds SIS. Combined pulmonary fibrosis and emphysema syndrome: a review. Chest 2012;141:222–231.
5. Özçelik N, Özsu S. A newly-defined entity: combined pulmonary fibrosis and emphysema syndrome [Article in Turkish]. Tuberk Toraks 2015; 63: 48–52.
6. Wiggins J, Strickland B, Turner-Warwick M. Combined cryptogenic fibrosing alveolitis and emphysema: the value of high resolution computed tomography in assessment. Respir Med 1990; 84: 365–369.
7. Cottin V, Nunes H, Brillet PY, DeLaval P, Devouassoux G, TillieLeblond I, et al. Groupe d’Etude et de Recherche sur les Maladies Orphelines Pulmonaires (GERM O P). Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. Eur Respir J 2005; 26: 586–593.
8. Çiftci F, Gülpınar B, Atasoy Ç, Kayacan O, Saryal S. Combined pulmonary fibrosis and emphysema: How does cohabitation affect respiratory functions? Advances in Medical Sciences 2019; 64: 285–291.
9. Jankowich MD, Rounds SIS. Combined pulmonary fibrosis and emphysema syndrome. A Review. Chest 2012;141:222–231.
10. Kusko RL, Brothers 2nd JF, Tedrow J, Pandit K, Huleihel L, Perdomo C, et al. Integrated genomics reveals convergent transcriptomic networks underlying chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2016;194:948–960.
11. Huijin Lin, Shanping Jiang. Combined pulmonary fibrosis and emphysema (CPFE): an entity different from emphysema or pulmonary fibrosis alone. Thorac Dis 2015;7(4):767-779.
12. Wu X, Kim GH, Salisbury ML, Barber D, Bartholmai BJ, Brown KK, et al. Computed Tomographic Biomarkers in Idiopathic Pulmonary Fibrosis. The Future of Quantitative Analysis. Am J Respir Crit Care Med 2019;199(1):12-21.
13. Nakagawa H, Ogawa E, Fukunaga K, Kinose D, Yamaguchi M, Nagao T et al. Quantitative CT analysis of honeycombing area predicts mortality in idiopathic pulmonary fibrosis with definite usual interstitial pneumonia pattern: A retrospective cohort study. PLoS ONE 2019;;14(3):e0214278.
14. Jacob J, Pienn M, Payer C, Urschler M, Kokosi M, Devaraj A et al. Quantitative CT-derived vessel metrics in idiopathic pulmonary fibrosis: A structure-function study. Respirology 2019;24(5):445-452.
15. Bak SH, Park HY, Nam JH, Lee HY, Lee JH, Sohn I et al. Predicting clinical outcome with phenotypic clusters using quantitative CT fibrosis and emphysema features in patients with idiopathic pulmonary fibrosis. PLoS One 2019;14(4):e0215303.
16. Raghu G, Remy-Jardin M, Myers JL, Richeldi L, Ryerson CJ, Lederer DJ, et al. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2018;198(5):e44–e68.
17. Ryerson CJ, Hartman T, Elicker BM, Ley B, Lee JS, Abbritti M, et al. Clinical features and outcomes in combined pulmonary fibrosis and emphysema in idiopathic pulmonary fibrosis. Chest 2013;144(1):234–240.
18. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R et al. General considerations for lung function testing. Eur Respir J 2005; 26: 153–161.
19. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005; 26: 319–338.
20. Wanger J, Clausen JL, Coates A, Pedersen OF, Brusasco V, Burgos F, et al. Standardisation of the measurement of lung volumes. Eur Respir J 2005; 26: 511–522.
21. Single breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique. Statement of the American Thoracic Society. Am Rev Respir Dis 1987; 136:1299.
22. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification. Eur J Echocardiogr 2006; 7: 79–108.
23. Barst RJ, McGoon M, Torbicki A, Sitbon O, Krowka MJ, Olschewski H, et al. Diagnosis and differential assessment of pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43: Suppl. S, 40S–47S.
24. Joppa P, Petrasova D, Stancak B, Tkacova R. Systemic inflammation in patients with COPD and pulmonary hypertension. Chest 2006; 130: 326–333.
25. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010; 23: 685–713.
26. Jiang C, Fu Q, Zheng C. Prognosis of combined pulmonary fibrosis and emphysema: comparison with idiopathic pulmonary fibrosis alone. Ther Adv Respir Dis 2019, Vol. 13: 1–7.
27. Sugino K, Ishida F, Kikuchi N, Hirota N, Sano G, Sato K et al. Comparison of clinical characteristics and prognostic factors of combined pulmonary fibrosis and emphysema versus idiopathic pulmonary fibrosis alone. Respirology 2014; 19: 239–245.
28. Jankowich MD, Rounds SIS. Combined pulmonary fibrosis and emphysema syndrome: a review. Chest 2012; 141(1): 222–231.
29. Zhang L, Zhang C, Dong F, Song Q Chi F, Liu L, et al. Combined pulmonary fibrosis and emphysema: a retrospective analysis of clinical characteristics, treatment and prognosis. BMC Pulm Med 2016; 16(1): 137.
30. Cottin V, Le Pavec J, Prévot G, Mal H, Humbert M, Simonneau G, et al. Pulmonary hypertension in patients with combined pulmonary fibrosis and emphysema syndrome. Eur Respir J 2010; 35:105-11.
31. Torrisi SE, Palmucci S, Stefano A, Russo G, Torcitto AG, Falsaperla D, et al. Assessment of survival in patients with idiopathic pulmonary fibrosis using quantitative HRCT indexes. Multidisciplinary Respiratory Medicine 2018; 13: 43.

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