To determine if the CT findings of patients with sarcoidosis are useful in predicting the prognosis of the disease.
The study took place in a large urban teaching hospital. We identified patients with the diagnosis of sarcoidosis who also had Chest CT scans over a 15 years period beginning in 1992. All patients 18 years of age or older who carry the diagnosis of sarcoidosis in our PFT database were included. Then we further selected the patients by reviewing charts and also reviewing the CT database. Patients are selected among this group who have CT Chest within 3 months of a PFT study and also have a follow-up PFT after the initial 3 months period. We constructed a database that included patient characteristics, PFT findings, and CT findings. Associations between each chest CT characteristic and initial PFT results and changes in serial PFTs were analyzed by means of t-test.
A total of 47 patients were identified in our database who met the criteria. Mean age was 45.6 years old (25–77). Mean duration of disease at the time of CT chest was 5 years. The CT finding of fibrosis was significantly correlated with lower initial FEV1%predicted(with/without 68.7% vs. 80.6%, p = 0.02) and lower initialDLCO%predicted (53.2% vs. 68.3%, p = 0.01). The CT finding of nodules was associated with higher FVC%predicted (With/Without 84.1% vs. 70.9%, p = 0.007), FEV1%predicted (80.3% vs. 67%, p = 0.02), and DLCO%predicted (65.9% vs. 55.3%, p = 0.04). Ground glass opacities and consolidations are not significantly associated with initial PFT results. None of the CT findings were consistently associated with either improvement ordeterioration of serial PFT results.
CT evidence for fibrosis and nodules were associated with worse and better baseline pulmonary function, respectively. However, CT findings were not useful to predict improvement or deterioration of subsequent pulmonary function.
In patients with sarcoidosis chest CT is useful in assessing the current pulmonary function, but is not useful to predict prognosis for subsequent pulmonary function improvement or deterioration.
Daisuke Takekoshi, No Financial Disclosure Information; No Product/Research Disclosure Information