title: Radiologic-pathologic discordance in biopsy-proven usual interstitial pneumonia.
abstract: The aim of this study was to compare the clinical, radiological and histological findings in a large population of subjects enrolled during a multicentre study of idiopathic pulmonary fibrosis, with a focus on discordance between imaging and histologic diagnoses of usual interstitial pneumonia (UIP).Two independent radiologists retrospectively reviewed 241 subjects who underwent high-resolution computed tomography (HRCT) and surgical lung biopsies. HRCT findings were classified as UIP, possible UIP and inconsistent with UIP. Histological findings were classified as definite, probable, possible and not UIP.Of the 241 cases, 102 (42.3%) had HRCT findings of UIP, 64 (26.6%) had possible UIP and 75 (31.1%) were inconsistent with UIP. Among those with UIP on HRCT, 99 (97.1%) had histologically definite or probable UIP (concordant group), and 71 (94.7%) of those with "inconsistent" HRCT features had histologically definite or probable UIP (discordant group). Discordant subjects were slightly younger and less likely to be smokers than concordant subjects, but no survival differences were identified.In this population of patients enrolled with a diagnosis of idiopathic pulmonary fibrosis, 94.7% of those with HRCT findings "inconsistent with UIP" demonstrated histological UIP. This suggests that the term "inconsistent with UIP" is misleading.
authors.affiliation: Dept of Radiology, St Marianna University School of Medicine, Kanagawa, Japan Dept of Radiology, National Jewish Health, Denver, CO, USA Dept of Radiology, St Luke's International Hospital, Tokyo, Japan k2yagihashi@marianna-u.ac.jp.
authors.forename: Kunihiro
authors.identifier: http://orcid.org/0000-0002-3223-0842
authors.initials: K
authors.lastname: Yagihashi
authors.affiliation: Dept of Radiology, CPMG Kaiser Colorado, Denver, CO, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Huckleberry
authors.affiliation: Dept of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Colby
authors.affiliation: Dept of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Henry D
authors.initials: HD
authors.lastname: Tazelaar
authors.affiliation: Dept of Radiology, National Jewish Health, Denver, CO, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Zach
authors.affiliation: Dept of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Baskaran
authors.initials: B
authors.lastname: Sundaram
authors.affiliation: Dept of Radiology, University of Washington, Seattle, WA, USA.
authors.forename: Sudhakar
authors.initials: S
authors.lastname: Pipavath
authors.affiliation: Dept of Medicine, University of Colorado Denver, School of Medicine, Aurora, CO, USA.
authors.forename: Marvin I
authors.initials: MI
authors.lastname: Schwarz
authors.affiliation: Dept of Radiology, National Jewish Health, Denver, CO, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
mesh_terms: D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014481:United States