title: Visually stratified CT honeycombing as a survival predictor in combined pulmonary fibrosis and emphysema.
abstract: OBJECTIVE
  To determine whether visually stratified CT findings and pulmonary function variables are helpful in predicting mortality in patients with combined pulmonary fibrosis and emphysema (CPFE).
  
  
  METHODS
  We retrospectively identified 113 patients with CPFE who underwent high-resolution CT between January 2004 and December 2009. The extent of emphysema and fibrosis on CT was visually assessed using a 6- or 5-point scale, respectively. Univariate and multivariate Cox proportional regression analyses were performed to determine the prognostic value of visually stratified CT findings and pulmonary function variables in patients with CPFE. Differences in 5-year survival rates in patients with CPFE according to the extent of honeycombing were calculated using Kaplan-Meier analysis.
  
  
  RESULTS
  An increase in the extent of visually stratified honeycombing on CT [hazard ratio (HR), 1.95; p = 0.018; 95% confidence interval (CI), 1.12-3.39] and reduced diffusing capacity of lung for carbon monoxide (DLCO) (HR, 0.97; p = 0.017; 95% CI, 0.94-0.99) were independently associated with increased mortality. In patients with CPFE, the 5-year survival rate was 78.5% for <5% honeycombing, 55.7% for 5-25% honeycombing, 32% for 26-50% honeycombing and 33.3% for >50% honeycombing on CT.
  
  
  CONCLUSIONS
  The >50% honeycombing on CT and reduced DLCO are important prognostic factors in CPFE.
  
  
  CONCLUSIONS
  Visual estimation of honeycombing extent on CT can help in the prediction of prognosis in CPFE.
authors.affiliation: 1 Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
authors.forename: Yong Seek
authors.initials: YS
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
authors.forename: Gong Yong
authors.initials: GY
authors.lastname: Jin
authors.affiliation: 1 Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
authors.forename: Kum Ju
authors.initials: KJ
authors.lastname: Chae
authors.affiliation: 1 Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Han
authors.affiliation: 1 Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
authors.forename: Su Bin
authors.initials: SB
authors.lastname: Chon
authors.affiliation: 1 Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Lee
authors.affiliation: 2 Department of Preventive Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea.
authors.forename: Keun Sang
authors.initials: KS
authors.lastname: Kwon
authors.affiliation: 3 Department of Statistics, Chonbuk National University, Jeonju, Republic of Korea.
authors.forename: Hye Mi
authors.initials: HM
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*