title: Imaging patterns and prognosis of patients with gefitinib-related interstitial lung disease.
abstract: OBJECTIVE
  We aimed to summarize the imaging findings of 25 patients with gefitinib-related interstitial lung disease (ILD), and identify the factors related to prognosis of gefitinib-related ILD in patients with non-small-cell-lung cancer.
  
  
  METHODS
  Diagnosis of gefitinib-induced ILD by at least two chest radiologists was based on a review and analysis of the chest radiography and CT findings plus clinical data in the medical records. All patients were diagnosed with Stage III - IV non-small-cell carcinoma (adenocarcinoma (n = 24), bronchioalveolar cell carcinoma (n = 1)) and essential clinical data such as gefitinib as first-line use and survival status were recorded and analyzed to determine whether these were prognosis predictors. The imaging findings were classified into four patterns according to the previous largest study in Japan.
  
  
  RESULTS
  The 25 chest radiographs were classified as Pattern A (n = 8), Pattern B (n = 3), Pattern C (n = 6), and pattern D (n = 8). Likewise the 23 CT images were classified as pattern A (n = 8; 34.8%), B (n = 3; 13%), C (n = 5; 21.7%), and D (n = 7; 30.4%). The mortality rate was significantly higher in patients with pattern D than in patients with the other patterns. Pattern D imaging findings were also significantly correlated with non first-line use of gefitinib (p = 0.007).
  
  
  CONCLUSIONS
  We found an increase in mortality rate in patients with gefitinib associated ILD/pattern D compared to other radiological patterns. Familiarity with these imaging patterns can facilitate early and accurate diagnosis and help physicians gauge clinical prognosis of gefitinib-related ILD.
authors.affiliation: Department of Radiology, National Yang-Ming University Hospital, Yilan, Taiwan.
authors.forename: M-K
authors.initials: MK
authors.lastname: Yuan
authors.forename: C-Y
authors.initials: CY
authors.lastname: Chang
authors.forename: S-C
authors.initials: SC
authors.lastname: Chang
authors.forename: S-J
authors.initials: SJ
authors.lastname: Chang
authors.forename: G-J
authors.initials: GJ
authors.lastname: Tang
authors.forename: Y-F
authors.initials: YF
authors.lastname: Wei
authors.forename: Y-C
authors.initials: YC
authors.lastname: Liu
authors.forename: C-Y
authors.initials: CY
authors.lastname: Chen
authors.forename: C-J
authors.initials: CJ
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000401:mortality; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011799:Quinazolines / Q000009:adverse effects*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib