Long-term follow-up high-resolution CT findings in non-specific interstitial pneumonia.
BACKGROUND
The aims of this study were to retrospectively assess the change in findings on follow-up CT scans of patients with non-specific interstitial pneumonia (NSIP; median, 72 months; range, 3-216 months) and to clarify the correlation between the baseline CT findings and mortality.


METHODS
The study included 50 patients with a histologic diagnosis of NSIP. Two observers evaluated the high-resolution CT (HRCT) findings independently and classified each case into one of the following three categories: (1) compatible with NSIP, (2) compatible with UIP or (3) suggestive of alternative diagnosis. The correlation between the HRCT findings and mortality was evaluated using the Kaplan-Meier method and the log-rank test, as well as Cox proportional hazards regression models.


RESULTS
Ground-glass opacity and consolidation decreased, whereas coarseness of fibrosis and traction bronchiectasis increased on the follow-up HRCT scans, however, in 78% of cases the overall extent of parenchymal abnormalities had no change or decreased. Patients with HRCT diagnosed compatible with NSIP had a longer survival than those with HRCT findings more compatible UIP or an alternative diagnosis. On multivariate analysis, the coarseness of fibrosis alone was associated with prognosis (HR: 1.480; 95% CIs 1.100 to 1.990).


CONCLUSIONS
The HRCT patterns seen in patients with a histopathologic diagnosis of NSIP progress in a variable manner. Overall disease extent may decrease over time in some, while fibrosis may progress in others. The initial HRCT diagnosis may impact survival in this group of patients.
Department of Radiology, NHO Kinki-Chuo Chest Medical Center, Sakai City, Osaka, Japan. akira@kch.hosp.go.jp
Masanori
M
Akira
Yoshikazu
Y
Inoue
Toru
T
Arai
Tomohisa
T
Okuma
Yutaka
Y
Kawata
D000328:Adult; D000368:Aged; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult