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Serial chest CT in cryptogenic organizing pneumonia: Evolutional changes and prognostic determinants
Author(s) -
Chung Man P.,
Nam Bo D.,
Lee Kyung S.,
Han Joungho,
Park Jai S.,
Hwang Jung H.,
Cha Min J.,
Kim Tae J.
Publication year - 2018
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13188
Subject(s) - medicine , high resolution computed tomography , radiology , univariate analysis , cryptogenic organizing pneumonia , multivariate analysis , lung , pneumonia , odds ratio , nuclear medicine , computed tomography
Background and objective Cryptogenic organizing pneumonia (COP) is corticosteroid responsive but residual computed tomography (CT) chest changes are often noted. The present study examined clinical and HRCT features of COP in which there was incomplete resolution. Methods We studied 93 patients with histopathologically confirmed COP and serial HRCT imaging. Clinical features were assessed, and serial CT images were analysed. Uni‐ and multivariate analyses were performed to determine clinical or imaging factors related to incomplete resolution on CT. Results Complete resolution on CT imaging was seen in 21/93 patients (23%) and residual abnormalities were seen in 72/93 patients (77%). In univariate analysis, total lesion ( P = 0.036), degree of consolidation ( P = 0.011), treatment duration ( P < 0.001) and single‐breath carbon monoxide diffusing capacity of lung ( P = 0.021) were significantly associated with residual imaging abnormalities. In multivariate analysis, extent of consolidation ( P = 0.018; odds ratio (OR) = 14.92) and treatment duration ( P = 0.011; OR = 1.32) remained as significant factors linked to residual abnormalities. CT images in unresolved COP were akin to fibrotic non‐specific interstitial pneumonia (fNSIP) in 53/72 (74%) patients. Conclusion Clinical, radiological and lung diffusion measurements were related to incomplete resolution on CT after COP. Imaging abnormalities on CT chest generally resembled fNSIP.