The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy: A prospective study

Jonathan B Orens, E. A. Kazerooni, F. J. Martinez, J. L. Curtis, B. H. Gross, A. Flint, J. P. Lynch

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)109-115
Number of pages7
JournalChest
Volume108
Issue number1
StatePublished - 1995
Externally publishedYes

Fingerprint

Idiopathic Pulmonary Fibrosis
Prospective Studies
Thorax
Biopsy
Lung
Tomography
Interstitial Lung Diseases
Dyspnea
Exercise
Pulmonary Gas Exchange
Respiratory Function Tests
Tertiary Healthcare
Motion Pictures
Gases
X-Rays

Keywords

  • high-resolution computed tomography
  • idiopathic pulmonary fibrosis
  • pulmonary function tests
  • sensitivity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Orens, J. B., Kazerooni, E. A., Martinez, F. J., Curtis, J. L., Gross, B. H., Flint, A., & Lynch, J. P. (1995). The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy: A prospective study. Chest, 108(1), 109-115.

The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy : A prospective study. / Orens, Jonathan B; Kazerooni, E. A.; Martinez, F. J.; Curtis, J. L.; Gross, B. H.; Flint, A.; Lynch, J. P.

In: Chest, Vol. 108, No. 1, 1995, p. 109-115.

Research output: Contribution to journalArticle

Orens, JB, Kazerooni, EA, Martinez, FJ, Curtis, JL, Gross, BH, Flint, A & Lynch, JP 1995, 'The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy: A prospective study', Chest, vol. 108, no. 1, pp. 109-115.
Orens, Jonathan B ; Kazerooni, E. A. ; Martinez, F. J. ; Curtis, J. L. ; Gross, B. H. ; Flint, A. ; Lynch, J. P. / The sensitivity of high-resolution CT in detecting idiopathic pulmonary fibrosis proved by open lung biopsy : A prospective study. In: Chest. 1995 ; Vol. 108, No. 1. pp. 109-115.
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