title: CT analysis of the effect of pirfenidone in patients with idiopathic pulmonary fibrosis.
abstract: OBJECTIVE
  Pirfenidone is a new, anti-fibrotic drug used for the treatment of idiopathic pulmonary fibrosis (IPF). The aim of this study was to evaluate the utility of computed tomography (CT) in the imaging assessment of the response to pirfenidone therapy.
  
  
  METHODS
  Subjects were 78 patients with IPF who underwent CT on two occasions with one-year interval (38 consecutive patients treated with pirfenidone and 40 age-matched control). Changes in the fibrous lesion on sequential CTs were assessed as visual score by two radiologists. We measured the volume and change per year of fibrous pattern (F-pattern) quantitatively using a computer-aided system on sequential CTs.
  
  
  RESULTS
  The baseline vital capacity (%pred VC) was 74.0 ± 14.0% in the pirfenidone group and 74.6 ± 16.6% in controls (p=NS). Deterioration of respiratory status was defined as 10% or greater decline in %pred VC value after 12-month treatment. A significantly larger proportion of pirfenidone-treated patients showed stable respiratory status (21 of 38, 65.6%) than the control (15 of 40, 37.5%). The change in fibrous lesion was significantly smaller in the pirfenidone group than the control in both of visual score (p=0.006) and computer analysis (p<0.001). The decline in VC correlated significantly with the increase in fibrotic lesion (p<0.001).
  
  
  CONCLUSIONS
  CT can be used to assess pirfenidone-induced slowing of progression of pulmonary fibrosis.
authors.affiliation: Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. Electronic address: tae_i_md@wb3.so-net.ne.jp.
authors.forename: Tae
authors.initials: T
authors.lastname: Iwasawa
authors.affiliation: Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ogura
authors.affiliation: Department of Diagnostic Radiology, International Medical Center of Saitama Medical University, Saitama, Japan.
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Sakai
authors.affiliation: Department of Radiology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kanauchi
authors.affiliation: Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Komagata
authors.affiliation: Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Baba
authors.affiliation: Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Gotoh
authors.affiliation: Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Yazawa
authors.affiliation: Department of Radiology Yokohama City University, School of Medicine, Yokohama, Japan.
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008168:Lung / Q000000981:diagnostic imaging* / Q000187:drug effects; D008297:Male; D011728:Pyridones / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D011728:Pyridones; C093844:pirfenidone