Chest
Original ResearchDiffuse Lung DiseaseAccuracy of Individual Variables in the Monitoring of Long-term Change in Pulmonary Sarcoidosis as Judged by Serial High-Resolution CT Scan Data
Section snippets
Materials and Methods
We reviewed data from 73 patients collected between January 1, 1993, and December 31, 2005, who met current clinical and histopathologic diagnostic criteria for pulmonary sarcoidosis.1 All patients had a baseline HRCT scan of the chest and a follow-up scan. Clinical data were extracted from case records (Table 1). As the aim of the study was to reconcile change in chest HRCT scan with changes in PFT indices and/or chest radiography, treatment effects were not specifically evaluated.
The
Chest Radiographic and HRCT Scan Change
There was good interobserver agreement for change in chest radiographic extent (weighted κ coefficient of variation [Kw] = 0.79, P < .0001) and for change in HRCT scan extent (Kw = 0.75, P < .0001). As shown in Table 2, change in disease extent was seen more frequently on HRCT scan (63 of 73, 86%) than on chest radiography (53 of 73, 73%) (P < .05). There was only moderate agreement between change in radiographic extent and change in HRCT scan disease extent (Kw = 0.46, P < .0001). There was
Discussion
We report that in pulmonary sarcoidosis, a monitoring strategy of quantifying spirometric trends in isolation provides good agreement with morphologic change on serial HRCT scan but is not improved by the integration of gas transfer or chest radiographic data. Isolated or disproportionate gas transfer decline was frequent, did not correlate with morphologic change, and should be studied further as a possible precursor to the development of pulmonary hypertension.
No attempt was made in this
Acknowledgments
Author contributions: Dr Zappala is guarantor of the study.
Dr Zappala: contributed to data collection, statistics, and manuscript preparation.
Dr Desai: contributed to imaging assessment and manuscript review.
Dr Copley: contributed to imaging assessment and manuscript review.
Dr Spagnolo: contributed to patient selection and manuscript review.
Mr Cramer: contributed to clinical measurement supervision and manuscript review.
Ms Sen: contributed to data collection and manuscript review.
Dr Alam:
References (0)
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Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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