Abstract
Purpose
The authors assessed the clinical usefulness of high-resolution computed tomography (HRCT) for monitoring sarcoidosis by comparing changes on HRCT with those on pulmonary function test (PFT) results over time.
Materials and methods
The baseline and follow-up (after 13 months, range 15–63 months) HRCT scans of 14 consecutive patients with sarcoidosis were reviewed by a single observer. Each follow-up HRCT examination was assessed as stable, improved (when the extent of HRCT findings was reduced compared with baseline) and worsened (when the extent of HRCT findings was increased and/or when HRCT pattern had become fibrotic compared with baseline). Any increase or decrease in forced vital capacity (FVC)≥10% from baseline was considered significant. Changes on HRCT were then compared with those on FVC.
Results
During a median follow-up of 33 (range 15–63) months, HRCT findings worsened in 8/14 (58%) cases, improved in 3/14 (21%) and remained stable in 3/14 (21%). Agreement between changes on HRCT and FVC was moderate (κ=0.49). In 9/14 (64%) cases, HRCT changes were in line with those on FVC. In 4/5 discordant cases, the worsened HRCT findings were not mirrored by FVC changes.
Conclusions
Despite the small size of our study population, our results suggest that HRCT may provide clinicians with additional information about the evolution of sarcoidosis.
Riassunto
Obiettivo
Scopo del presente lavoro è stato valutare l’utilità clinica della tomografia computerizzata ad alta risoluzione (HRCT) nel monitorare l’evoluzione della sarcoidosi, mettendo a confronto i cambiamenti della malattia alla HRCT con quelli delle prove di funzionalità respiratoria nel tempo.
Materiali e metodi
Abbiamo valutato i reperti ed i pattern HRCT di 14 pazienti con sarcoidosi all’esame iniziale ed a distanza di 33 (15–63 mesi) mesi di tempo. La malattia è stata valutata come: stabile, migliorata (per riduzione in estensione delle alterazioni) e peggiorata (per aumento in estensione delle alterazioni e/o evoluzione verso un pattern fibrotico). Una variazione del 10% della capacità vitale forzata (FVC) al follow-up rispetto al basale è stata considerata significativa. L’evoluzione nel tempo del quadro HRCT è stata posta a confronto con quella della FVC.
Risultati
All’esame HRCT di follow-up (mediana 33 mesi, intervallo 15–63 mesi), la malattia è apparsa peggiorata in 8/14 pazienti (57%), mentre è migliorata in 3/14 (21%) ed invariata in 3/14 (21%). La concordanza tra le variazioni HRCT e quelle della FVC è risultata moderata (k=0,49). In 9/14 pazienti (64%), i reperti HRCT e le FVC sono risultati concordanti circa l’evoluzione della malattia. In 4/5 casi discordanti, alla HRCT è stato riscontrato un peggioramento del quadro non dimostrato dalla variazione della FVC.
Conclusioni
I nostri risultati, sebbene ottenuti su una popolazione di studio limitata, suggeriscono che la HRCT può fornire al clinico informazioni complementari circa l’evoluzione della sarcoidosi.
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Gafà, G., Sverzellati, N., Bonati, E. et al. Follow-up in pulmonary sarcoidosis: comparison between HRCT and pulmonary function tests. Radiol med 117, 968–978 (2012). https://doi.org/10.1007/s11547-012-0827-5
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DOI: https://doi.org/10.1007/s11547-012-0827-5