TY - JOUR
T1 - The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy
T2 - A prospective study
AU - Orens, J. B.
AU - Kazerooni, E. A.
AU - Martinez, F. J.
AU - Curtis, J. L.
AU - Gross, B. H.
AU - Flint, A.
AU - Lynch, J. P.
N1 - Funding Information:
Supported in part by National Institutes of Health NHLBI grant P50HL46487, NIH/NCRR 3 MO1 RR00042-33S3, and by funds from the Clinical Research Center of the University of Michigan grant M01RR00042.
PY - 1995
Y1 - 1995
N2 - Objectives: To assess the sensitivity of high-resolution chest computed tomography (HRCT) in detecting idiopathic pulmonary fibrosis proved by biopsy specimen. To determine the degree of physiologic and pathologic abnormalities in patients with idiopathic pulmonary fibrosis who have a false-negative HRCT. Design: Prospective 2-year study. Setting: Tertiary care university hospital. Patients: All patients with dyspnea and suspected interstitial lung disease referred to the University of Michigan for enrollment in the Idiopathic Pulmonary Fibrosis Specialized Center of Research (SCOR) protocol were included; 25 underwent open lung biopsy and formed the final study group. Measurements: All patients underwent physiologic (pulmonary function, gas exchange, and exercise testing), radiologic (chest x-ray film and HRCT), and pathologic assessments (bronchoscopic and open lung biopsy). The results of HRCT were prospectively compared with results of standard pulmonary function tests, cardiopulmonary exercise testing, and open lung biopsy. Results: Of 25 patients who had both HRCT and open lung biopsy, 3 patients (12%) had HRCTs that demonstrated no evidence of interstitial lung disease. These three patients had less severe disease based on clinical, radiographic, and physiologic (CRP) scores, gas exchange abnormalities, and pathologic scoring of open lung biopsy specimens, compared with those with an abnormal HRCT. Conclusions: We conclude that in the evaluation of patients with dyspnea and abnormal results of pulmonary function studies, a normal HRCT does not exclude early and clinically significant interstitial lung disease. In our patient population, physiologic testing was more sensitive than HRCT in detecting mild abnormalities in patients with idiopathic pulmonary fibrosis proved by biopsy specimen.
AB - Objectives: To assess the sensitivity of high-resolution chest computed tomography (HRCT) in detecting idiopathic pulmonary fibrosis proved by biopsy specimen. To determine the degree of physiologic and pathologic abnormalities in patients with idiopathic pulmonary fibrosis who have a false-negative HRCT. Design: Prospective 2-year study. Setting: Tertiary care university hospital. Patients: All patients with dyspnea and suspected interstitial lung disease referred to the University of Michigan for enrollment in the Idiopathic Pulmonary Fibrosis Specialized Center of Research (SCOR) protocol were included; 25 underwent open lung biopsy and formed the final study group. Measurements: All patients underwent physiologic (pulmonary function, gas exchange, and exercise testing), radiologic (chest x-ray film and HRCT), and pathologic assessments (bronchoscopic and open lung biopsy). The results of HRCT were prospectively compared with results of standard pulmonary function tests, cardiopulmonary exercise testing, and open lung biopsy. Results: Of 25 patients who had both HRCT and open lung biopsy, 3 patients (12%) had HRCTs that demonstrated no evidence of interstitial lung disease. These three patients had less severe disease based on clinical, radiographic, and physiologic (CRP) scores, gas exchange abnormalities, and pathologic scoring of open lung biopsy specimens, compared with those with an abnormal HRCT. Conclusions: We conclude that in the evaluation of patients with dyspnea and abnormal results of pulmonary function studies, a normal HRCT does not exclude early and clinically significant interstitial lung disease. In our patient population, physiologic testing was more sensitive than HRCT in detecting mild abnormalities in patients with idiopathic pulmonary fibrosis proved by biopsy specimen.
KW - high-resolution computed tomography
KW - idiopathic pulmonary fibrosis
KW - pulmonary function tests
KW - sensitivity
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U2 - 10.1378/chest.108.1.109
DO - 10.1378/chest.108.1.109
M3 - Article
C2 - 7606943
AN - SCOPUS:0029018237
SN - 0012-3692
VL - 108
SP - 109
EP - 115
JO - CHEST
JF - CHEST
IS - 1
ER -