Abstract: Poster Presentations |

Integrating Clinical Assessment and Imaging in Interstitial Lung Disease (ILD) FREE TO VIEW

Roberto G. Carbone, MD, FCCP*; Rosangela Filiberti, PhD; Giovanni Bottino, DSc
Author and Funding Information

Pneumology, Regional Hospital, Aosta, Italy


Chest. 2004;126(4_MeetingAbstracts):891S. doi:10.1378/chest.126.4_MeetingAbstracts.891S-a
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PURPOSE:  The research deals with non-invasive methods for the diagnosis of ILD, aimed at avoiding surgical procedures and reducing medical costs.

METHODS:  We evaluated clinical symptoms, signs, and imaging of 71patients (pts) with ILD (median age 60 years, 42 % males). ILD subgroups included: usual interstitial pneumonia (UIP = 34), non-specific idiopathic pneumonia (NSIP=13), Wegener granulomatosis (WG =14), and extrinsic allergic alveolitis (EAA = 10), all pathologically confirmed. Surgical diagnosis performed by open pulmonary biopsy (n = 31), VATS (n=27) or percutaneous biopsy (n =13). A periodical imaging evaluation has been carried out independently by two radiologists and two respiratory physicians, and a high-resolution CT (HRCT) severity score (degrees = 0-4) has been calculated.

RESULTS:  NSIP pts were younger than UIP (p=0.001) or WG (p = 0.01). Cracklers were less common in NSIP than UIP (38% vs 100%; p<0.001), and were absent in WG and EAA. Fever was much more common in EAA than in NSIP (p=0.002), UIP (p=0.001), and WG (p<0.001). All UIP showed Octreoscan uptake index (UI) <10 (normal value ≤10). UI ranging from 10 to 12 UI was indicative of NSIP. It was indicative of WG and EAA when it was higher than 15 UI. A CT score with degree = 4 was indicative of UIP, while 100% of WG and EAA had score degree = 2.

CONCLUSION:  Age, signs (cracklers), fever and Octreoscan may be useful to differentiate among ILD subgroups. The diagnosis of UIP, the commonest ILD subgroup, may be achieved by using these parameters.

CLINICAL IMPLICATIONS:  Clinical parameters as well as imaging must be considered in assessing ILD. Diagnosis of UIP is possible avoiding surgical procedure and reducing medical costs.

DISCLOSURE:  R.G. Carbone, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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