CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2015; 25(01): 44-51
DOI: 10.4103/0971-3026.150144
Chest Radiology

HRCT in cystic fibrosis in patients with CFTR I1234V mutation: Assessment of scoring systems with low dose technique using multidetector system and correlation with pulmonary function tests

Venkatraman Bhat
Department of Radiology, Narayana Health, Bangalore, Karnataka, India
,
Atiqa Abdul Wahab
Department of Pediatrics, Hamad Medical Corporation, Doha, India
,
Kailash C Garg
Department of Radiology, Hamad Medical Corporation, Doha, India
,
Ibrahim Janahi
Department of Pediatrics, Hamad Medical Corporation, Doha, India
,
Rajvir Singh
Department of Biostastistics, Hamad Medical Corporation, Doha, India
› Institutsangaben
Financial support and sponsorship Nil.

Abstract

Background and Aims: Pulmonary changes in patients with cystic fibrosis (CF) with CFTR I1234V mutation have not been extensively documented. Impact of geographic influence on phenotypical expression is largely unknown. This descriptive clinical study presents the high-resolution computed tomography (HRCT) pulmonary findings and computed tomography (CT) scoring with respect to pulmonary function tests (PFT) in a small subset of CF group. Materials and Methods: We examined 29 patients between 2 and 31 years of age with CFTR I1234V mutation. HRCT and PFT were performed within 2 weeks of each other. Imaging abnormalities on HRCT were documented and analyzed by utilizing the scoring system described by Bhalla et al., Brody et al., Helbich et al.,and Santamaria et al. Efficacy of the scoring system with respect to PFT was compared. Statistical Analysis: Inter-observer reliability of the scoring systems was tested using intraclass correlation (ICC) between the two observers. Spearman correlation coefficients were calculated between the scoring systems and between the scoring systems and PFT results. Results: In our study, right upper and middle lobes were the most frequently involved sites of involvement. Bronchiectasis and peribronchial thickening were the most frequent imaging findings. Scores with all four scoring systems were reproducible, with good ICC coefficient of 0.69. There was good agreement between senior radiologists in all scoring systems. Conclusion: We noted pulmonary imaging abnormalities in a large majority (96%) of our CF patients. There was no significant difference in the CT scores observed from various systems. The CT evaluation system by Broody is detailed and time consuming, and is ideal for research and academic setup. On the other hand, the systems by Bhalla and Santamaria are easy to use, quick, and equally informative. We found the scoring system by Santamaria preferable over that of Bhalla by virtue of additional points of evaluation and ease of use, and therefore better suited for busy clinical practice.



Publikationsverlauf

Artikel online veröffentlicht:
30. Juli 2021

© 2015. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Stern M, Geddes D. Cystic fibrosis: Basic chemical and cellular mechanisms. Br JHosp Med 1996;55:237-40.
  • 2 Robinson TE. High-resolution CT scanning: Potential outcome measure. CurrOpinPulm Med 2004;10:537-41.
  • 3 Abdul Wahab A, AlThani G, Dawod ST, Kambouris M, Al Hamed M. Heterogeneity of the cystic fibrosis phenotype in a large kindred family in Qatar withcystic fibrosis mutation (I1234V). J Trop Pediatr 2001;47:110-2.
  • 4 Brody AS, Molina PL, Klein JS, Rothman BS, Ramagopal M, Swartz DR. High-resolution computed tomographyof the chest in children with cystic fibrosis: Support for use as an outcome surrogate. PediatrRadiol 1999;29:731-5.
  • 5 Dakin CJ, Pereira JK, Henry RL, Wang H, Morton JR. Relationship between sputum inflammatory markers, lung function, and lung pathology on high-resolution computed tomography in children with cystic fibrosis. PediatrPulmonol 2002;33:475-82.
  • 6 de Jong PA, Ottink MD, Robben SG, Lequin MH, Hop WC, Hendriks JJ, et al. Pulmonary disease assessment in cystic fibrosis: Comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 2004;231:434-9.
  • 7 Demirkazik FB, Ariyürek OM, Ozçelik U, Göçmen A, Hassanabad HK, Kiper N. High resolution CT in children with cystic fibrosis: Correlation with pulmonary functions and radiographic scores. Eur J Radiol2001;37:54-9.
  • 8 Castile RG, Hays JR, Flucke RL, Long FR, McCoy KS. Correlation of structureal and functional abnormalities in the lungs of infants with cystic fibrosis. PediatrPulmonol 2000;20:A427.
  • 9 Koh DM, Hansell DM. Computed tomography of diffuse interstitial lung disease in children. ClinRadiol2000;55:659-67.
  • 10 American Thoracic Society. Guidelines for assessing and managing asthma risk at work, school, and recreation. AmJ RespirCrit Care Med 2004;169:873-81.
  • 11 Bhalla M, Turcios N, AponteV, Jenkins M, Leitman BS, McCauley DI, et al. Cystic fibrosis: Scoring system with thin-section CT. Radiology1991;179:783-8.
  • 12 Brody AS. Scoring systems for CT in cystic fibrosis: Who cares? Radiology 2004;231:296-8.
  • 13 Helbich TH, Heinz-Peer G, Eichler I, Wunderbaldinger P, Götz M, Wojnarowski C, et al. Cystic fibrosis: CT assessment of lung involvement inchildren and adults. Radiology 1999;213:537-44.
  • 14 Santamaria F, Grillo G, Guidi G, Rotondo A, Raia V, de Ritis G, et al. Cystic fibrosis: When should high-resolution computed tomography of the chest be obtained? Pediatrics 1998;101:908-13.
  • 15 De Jong PA, Nakano Y, Lequin MH, Mayo JR, Woods R, Paré PD, et al. Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis. EurRespir J 2004;23:93-7.
  • 16 Aziz ZA, Davies JC, Alton EW, Wells AU, Geddes DM, Hansell DM. Computed tomography and cystic fibrosis: Promises and problems. Thorax 2007;62;181-6.
  • 17 Robinson TE. Computed tomography scanning techniques for the evaluation of cystic fibrosis lung disease. Proc Am ThoracSoc2007;4:310-5.
  • 18 Goris ML, Zhu HJ, Blankenberg F, Chan F, Robinson TE. An automated approach to quantitative air trapping measurements in mild cystic fibrosis. Chest 2003;123:1655-63.
  • 19 Lucaya J, Piqueras J, García-Peña P, Enríquez G, García-Macías M, Sotil J. Low-dose high-resolution CT of the chest in children and young adults: Dose, cooperation, artifact incidence, and image quality. AJR Am J Roentgenol2000;175:985-92.
  • 20 Hara AK, Paden RG, Silva AC, Kujak JL, LawderHJ, Pavlicek W. Iterative reconstruction technique for reducing body radiation dose at CT: Feasibility study. AJR Am J Roentgenol2009;193:764-71.