Pneumologie 2019; 73(S 01)
DOI: 10.1055/s-0039-1678276
Posterbegehung (P22) – Sektion Klinische Pneumologie
Fortschritte bei ILD
Georg Thieme Verlag KG Stuttgart · New York

Lung CT densitometry in IPF for the prediction of disease severity and mortality

D Löh
1   Pneumologische Klinik Waldhof Elgershausen, European Ipf Registry & Biobank (Euripfreg), Universities of Gießen and Marburg Lung Center (Ugmlc), Member of the German Center for Lung Research (Dzl), Excellence Cluster Cardiopulmonary System (Eccps), Gießen, Germany
,
L Brylski
1   Pneumologische Klinik Waldhof Elgershausen, European Ipf Registry & Biobank (Euripfreg), Universities of Gießen and Marburg Lung Center (Ugmlc), Member of the German Center for Lung Research (Dzl), Excellence Cluster Cardiopulmonary System (Eccps), Gießen, Germany
,
D von der Beck
1   Pneumologische Klinik Waldhof Elgershausen, European Ipf Registry & Biobank (Euripfreg), Universities of Gießen and Marburg Lung Center (Ugmlc), Member of the German Center for Lung Research (Dzl), Excellence Cluster Cardiopulmonary System (Eccps), Gießen, Germany
,
W Seeger
2   Universitätsklinikum Gießen, Zentrum für Innere Medizin, Medizinische Klinik II
,
E Krauss
1   Pneumologische Klinik Waldhof Elgershausen, European Ipf Registry & Biobank (Euripfreg), Universities of Gießen and Marburg Lung Center (Ugmlc), Member of the German Center for Lung Research (Dzl), Excellence Cluster Cardiopulmonary System (Eccps), Gießen, Germany
,
P Bonniaud
3   Institut National de la Santé et de la Recherche Médicale, Université de Bourgogne
,
C Vancheri
4   Regional Center for Interstitial and Rare Lung Diseases, University of Catania, Italy
,
A Wells
5   Interstitial Lung Unit, Royal Brompton Hospital, London, UK
,
P Markart
6   Klinikum Fulda, Medizinische Klinik V
,
A Breithecker
7   Universitätsklinikum Gießen & Marburg GmbH, Standort Gießen, Zentrum für Radiologie
,
A Günther
8   Univ.-Klinikum Gießen, Med. Klinik II, Schwerpunkt Pneumologie
› Author Affiliations
Further Information

Publication History

Publication Date:
19 February 2019 (online)

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    Introduction In this study, we retrospectively assessed the relation between physiological measurements, survival and quantitative computed tomographic (HRCT) indexes in patients with idiopathic pulmonary fibrosis (IPF).

    Methods 70 patients (48 male; mean age, 66.3 years ± (SD) 9.0) with IPF were enrolled in the study. Patients underwent thin-section CT in the supine position at full inspiration. After segmentation of the lungs, mean lung attenuation (MLA), skewness, kurtosis, peak-attenuation, total lung area, inflexion point with slope and the area right of the inflexion point (AROIP) were assessed. FVC, FEV1, TLC, DLCO and 6-minute walking distance (6MWT) were measured. Univariate and multivariate analysis were used for the prediction of physiological outcomes by HRCT indexes. These factors were then related to survival in a proportional hazards analysis.

    Results The strongest correlation was observed between MLA and FEV1 with an r of −0.63. Mean lung attenuation, peak attenuation, slope, attenuation and area right of inflexion point correlated negatively with all physiological measurements. AROIP was the best predictor of DLCO. Univariate regression analysis for prediction of mortality showed that AROIP, kurtosis and FVC were significantly related to survival. Multivariate regression revealed only a significant impact of AROIP on survival.

    Discussion These data indicate that HRCT indexes are correlated to physiological measurements. The newly defined parameter AROIP is of additive value for the prediction especially of DLCO and survival.


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