Assessment of pulmonary disease by Low Dose CT and spirometry in CF patients wiht moderate disease: a comparison

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Abstract

Purpose: With improving treatment, classic spirometry may not be sen-sitive enough to assess and differentiate pulmonary involvement in CF sub-jects with minor to moderate disease. The aim of this study was to comparefindings of spirometry to those of the low dose CT (LDCT), using the Bhal-la CT scoring system.Materials and Methods: Thirty-eight patients with CF, presenting fortheir yearly pulmonary assessment, underwent spirometry and LDCT in astable condition. All CT scans were randomized and rated independently by2 experienced staff radiologists, blinded to clinical information. Radiationdose was calculated. The Bhalla CT-scoring system was used to rate theimages defining severity and extent of bronchiectasis, peribronchial thicken-ing, generations of bronchial divisions involved, sacculations or abscesses,extent of mucous plugging, collapse or consolidation and number of bullae. Results: The age of the patients (22 males and 16 females) ranged from6 to 58 years (median age: 17 years); 42% being younger than 15 years.Mean FEV1was 83% +/- 23.6, indicating that patients had a wide range oflung disease, but mostly with mild impairment and normal FEV1. Meaneffective radiation dose for LDCT was 0.51 mSv +/- 0.56 mSv for patientsyounger than 15 years, and 1.54 mSv +/- 1.32 mSv for patients older than 15years, compared to 0.028 mSv +/- 0.010 mSv for a PA chest radiograph. Themedian Bhalla score was 7 (range 1-18; highest possible score: 25). Therewas excellent interobserver agreement (r= 0.99). The LDCT scores correlated well with FEV1(rs= -0.77, p<0.001),FEF25-75(rs= -0.73, p<0.001), FVC (rs= -0.64, p<0.001) and FEV1/FVC (rs=-0.73, p<0.001). The strongest linear association was found between LDCTscore and FEV1, and FEF25-75respectively.Conclusion: Low dose CT scores correlate well with FEV1values, andseem to detect more lung abnormalities than suggested by mean normalFEV1values in this group of CF patients. More work is needed to furtherlower radiation dose, so that the latter is not a drawback for repetitive inves-tigation.
Original languageEnglish
Pages (from-to)306-306
Number of pages1
JournalPediatric Pulmonology
Volume47
Issue numberS35
Publication statusPublished - 2012
Event26th Annual North American Cystic Fibrosis Conference - Orlando, United States
Duration: 11 Oct 201213 Oct 2012

Keywords

  • pulmonary
  • ct
  • low dose
  • cystic fibrosis

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