Pathologically proved nonspecific interstitial pneumonia: CT pattern analysis as compared with usual interstitial pneumonia CT Pattern

Hiromitsu Sumikawa, Takeshi Johkoh, Kiminori Fujimoto, Hiroaki Arakawa, Tomas V. Colby, Junya Fukuoka, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kensuke Kataoka, Takashi Ogura, Tomohisa Baba, Kazuya Ichikado, Tomoko Gyobu, Masahiro Yanagawa, Osamu Honda, Noriyuki Tomiyama

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Abstract

Purpose: To assess the variability of computed tomography (CT) patterns in patients with pathologic nonspecific interstitial pneumonia (NSIP) and to evaluate correlation of CT patterns with new idiopathic pulmonary fibrosis (IPF) classification guidelines, including pathologic diagnosis and predicted mortality. Materials and Methods: The ethical review boards of the five institutions that contributed cases waived the need for informed consent for retrospective review of patient records and images. The study included 114 patients with (a) a pathologic diagnosis of idiopathic NSIP (n = 39) or (b) a pathologic diagnosis of usual interstitial pneumonia (UIP) and a clinical diagnosis of IPF (n = 75). Two groups of independent observers evaluated the extent and distribution of various CT findings and identified the following five patterns: UIP, possible UIP, indeterminate (either UIP or NSIP), NSIP, and suggestive of an alternative diagnosis. CT findings were compared with pathologic diagnoses and outcome from clinical findings by using the log-rank test and Kaplan-Meier curves. Results: Radiologists classified 17 cases as UIP, 24 as possible UIP, 13 as indeterminate (either UIP or NSIP), and 56 as NSIP. In 35 of 39 patients with pathologic NSIP, a diagnosis of NSIP was made with CT. On the basis of CT interpretations, the mean overall survival time of patients with UIP, possible UIP, indeterminate findings, or NSIP was 33.5, 73.0, 101.0, and 140.2 months, respectively. Outcome of patients with a CT diagnosis of UIP was significantly worse than that of patients with a pattern of possible UIP, indeterminate findings, or NSIP (log-rank test: P = .013, P = .018, and P < .001, respectively). Conclusion: CT pattern in patients with pathologic NSIP is more uniform than that in patients with pathologic UIP, and CT NSIP pattern is associated with better patient outcome than is CT UIP pattern.

Original languageEnglish (US)
Pages (from-to)549-556
Number of pages8
JournalRadiology
Volume272
Issue number2
DOIs
StatePublished - 2014

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Idiopathic Pulmonary Fibrosis
Interstitial Lung Diseases
Tomography
Ethical Review
Idiopathic Interstitial Pneumonias
Kaplan-Meier Estimate
Informed Consent

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Sumikawa, H., Johkoh, T., Fujimoto, K., Arakawa, H., Colby, T. V., Fukuoka, J., ... Tomiyama, N. (2014). Pathologically proved nonspecific interstitial pneumonia: CT pattern analysis as compared with usual interstitial pneumonia CT Pattern. Radiology, 272(2), 549-556. https://doi.org/10.1148/radiol.14130853

Pathologically proved nonspecific interstitial pneumonia : CT pattern analysis as compared with usual interstitial pneumonia CT Pattern. / Sumikawa, Hiromitsu; Johkoh, Takeshi; Fujimoto, Kiminori; Arakawa, Hiroaki; Colby, Tomas V.; Fukuoka, Junya; Taniguchi, Hiroyuki; Kondoh, Yasuhiro; Kataoka, Kensuke; Ogura, Takashi; Baba, Tomohisa; Ichikado, Kazuya; Gyobu, Tomoko; Yanagawa, Masahiro; Honda, Osamu; Tomiyama, Noriyuki.

In: Radiology, Vol. 272, No. 2, 2014, p. 549-556.

Research output: Contribution to journalArticle

Sumikawa, H, Johkoh, T, Fujimoto, K, Arakawa, H, Colby, TV, Fukuoka, J, Taniguchi, H, Kondoh, Y, Kataoka, K, Ogura, T, Baba, T, Ichikado, K, Gyobu, T, Yanagawa, M, Honda, O & Tomiyama, N 2014, 'Pathologically proved nonspecific interstitial pneumonia: CT pattern analysis as compared with usual interstitial pneumonia CT Pattern', Radiology, vol. 272, no. 2, pp. 549-556. https://doi.org/10.1148/radiol.14130853
Sumikawa, Hiromitsu ; Johkoh, Takeshi ; Fujimoto, Kiminori ; Arakawa, Hiroaki ; Colby, Tomas V. ; Fukuoka, Junya ; Taniguchi, Hiroyuki ; Kondoh, Yasuhiro ; Kataoka, Kensuke ; Ogura, Takashi ; Baba, Tomohisa ; Ichikado, Kazuya ; Gyobu, Tomoko ; Yanagawa, Masahiro ; Honda, Osamu ; Tomiyama, Noriyuki. / Pathologically proved nonspecific interstitial pneumonia : CT pattern analysis as compared with usual interstitial pneumonia CT Pattern. In: Radiology. 2014 ; Vol. 272, No. 2. pp. 549-556.
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abstract = "Purpose: To assess the variability of computed tomography (CT) patterns in patients with pathologic nonspecific interstitial pneumonia (NSIP) and to evaluate correlation of CT patterns with new idiopathic pulmonary fibrosis (IPF) classification guidelines, including pathologic diagnosis and predicted mortality. Materials and Methods: The ethical review boards of the five institutions that contributed cases waived the need for informed consent for retrospective review of patient records and images. The study included 114 patients with (a) a pathologic diagnosis of idiopathic NSIP (n = 39) or (b) a pathologic diagnosis of usual interstitial pneumonia (UIP) and a clinical diagnosis of IPF (n = 75). Two groups of independent observers evaluated the extent and distribution of various CT findings and identified the following five patterns: UIP, possible UIP, indeterminate (either UIP or NSIP), NSIP, and suggestive of an alternative diagnosis. CT findings were compared with pathologic diagnoses and outcome from clinical findings by using the log-rank test and Kaplan-Meier curves. Results: Radiologists classified 17 cases as UIP, 24 as possible UIP, 13 as indeterminate (either UIP or NSIP), and 56 as NSIP. In 35 of 39 patients with pathologic NSIP, a diagnosis of NSIP was made with CT. On the basis of CT interpretations, the mean overall survival time of patients with UIP, possible UIP, indeterminate findings, or NSIP was 33.5, 73.0, 101.0, and 140.2 months, respectively. Outcome of patients with a CT diagnosis of UIP was significantly worse than that of patients with a pattern of possible UIP, indeterminate findings, or NSIP (log-rank test: P = .013, P = .018, and P < .001, respectively). Conclusion: CT pattern in patients with pathologic NSIP is more uniform than that in patients with pathologic UIP, and CT NSIP pattern is associated with better patient outcome than is CT UIP pattern.",
author = "Hiromitsu Sumikawa and Takeshi Johkoh and Kiminori Fujimoto and Hiroaki Arakawa and Colby, {Tomas V.} and Junya Fukuoka and Hiroyuki Taniguchi and Yasuhiro Kondoh and Kensuke Kataoka and Takashi Ogura and Tomohisa Baba and Kazuya Ichikado and Tomoko Gyobu and Masahiro Yanagawa and Osamu Honda and Noriyuki Tomiyama",
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T1 - Pathologically proved nonspecific interstitial pneumonia

T2 - CT pattern analysis as compared with usual interstitial pneumonia CT Pattern

AU - Sumikawa, Hiromitsu

AU - Johkoh, Takeshi

AU - Fujimoto, Kiminori

AU - Arakawa, Hiroaki

AU - Colby, Tomas V.

AU - Fukuoka, Junya

AU - Taniguchi, Hiroyuki

AU - Kondoh, Yasuhiro

AU - Kataoka, Kensuke

AU - Ogura, Takashi

AU - Baba, Tomohisa

AU - Ichikado, Kazuya

AU - Gyobu, Tomoko

AU - Yanagawa, Masahiro

AU - Honda, Osamu

AU - Tomiyama, Noriyuki

PY - 2014

Y1 - 2014

N2 - Purpose: To assess the variability of computed tomography (CT) patterns in patients with pathologic nonspecific interstitial pneumonia (NSIP) and to evaluate correlation of CT patterns with new idiopathic pulmonary fibrosis (IPF) classification guidelines, including pathologic diagnosis and predicted mortality. Materials and Methods: The ethical review boards of the five institutions that contributed cases waived the need for informed consent for retrospective review of patient records and images. The study included 114 patients with (a) a pathologic diagnosis of idiopathic NSIP (n = 39) or (b) a pathologic diagnosis of usual interstitial pneumonia (UIP) and a clinical diagnosis of IPF (n = 75). Two groups of independent observers evaluated the extent and distribution of various CT findings and identified the following five patterns: UIP, possible UIP, indeterminate (either UIP or NSIP), NSIP, and suggestive of an alternative diagnosis. CT findings were compared with pathologic diagnoses and outcome from clinical findings by using the log-rank test and Kaplan-Meier curves. Results: Radiologists classified 17 cases as UIP, 24 as possible UIP, 13 as indeterminate (either UIP or NSIP), and 56 as NSIP. In 35 of 39 patients with pathologic NSIP, a diagnosis of NSIP was made with CT. On the basis of CT interpretations, the mean overall survival time of patients with UIP, possible UIP, indeterminate findings, or NSIP was 33.5, 73.0, 101.0, and 140.2 months, respectively. Outcome of patients with a CT diagnosis of UIP was significantly worse than that of patients with a pattern of possible UIP, indeterminate findings, or NSIP (log-rank test: P = .013, P = .018, and P < .001, respectively). Conclusion: CT pattern in patients with pathologic NSIP is more uniform than that in patients with pathologic UIP, and CT NSIP pattern is associated with better patient outcome than is CT UIP pattern.

AB - Purpose: To assess the variability of computed tomography (CT) patterns in patients with pathologic nonspecific interstitial pneumonia (NSIP) and to evaluate correlation of CT patterns with new idiopathic pulmonary fibrosis (IPF) classification guidelines, including pathologic diagnosis and predicted mortality. Materials and Methods: The ethical review boards of the five institutions that contributed cases waived the need for informed consent for retrospective review of patient records and images. The study included 114 patients with (a) a pathologic diagnosis of idiopathic NSIP (n = 39) or (b) a pathologic diagnosis of usual interstitial pneumonia (UIP) and a clinical diagnosis of IPF (n = 75). Two groups of independent observers evaluated the extent and distribution of various CT findings and identified the following five patterns: UIP, possible UIP, indeterminate (either UIP or NSIP), NSIP, and suggestive of an alternative diagnosis. CT findings were compared with pathologic diagnoses and outcome from clinical findings by using the log-rank test and Kaplan-Meier curves. Results: Radiologists classified 17 cases as UIP, 24 as possible UIP, 13 as indeterminate (either UIP or NSIP), and 56 as NSIP. In 35 of 39 patients with pathologic NSIP, a diagnosis of NSIP was made with CT. On the basis of CT interpretations, the mean overall survival time of patients with UIP, possible UIP, indeterminate findings, or NSIP was 33.5, 73.0, 101.0, and 140.2 months, respectively. Outcome of patients with a CT diagnosis of UIP was significantly worse than that of patients with a pattern of possible UIP, indeterminate findings, or NSIP (log-rank test: P = .013, P = .018, and P < .001, respectively). Conclusion: CT pattern in patients with pathologic NSIP is more uniform than that in patients with pathologic UIP, and CT NSIP pattern is associated with better patient outcome than is CT UIP pattern.

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