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Tesi etd-07172018-122945


Thesis type
Tesi di specializzazione (5 anni)
Author
FIORINI, SARA
URN
etd-07172018-122945
Title
Evaluation of prognosis and disease progression in IPF patients using quantitative and visual CT score
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Commissione
relatore Prof. Caramella, Davide
correlatore Dott.ssa Romei, Chiara
Parole chiave
  • progression
  • prognosis
  • visual score
  • CALIPER
  • IPF
  • HRCT
  • idiopathic pulmonary fibrosis
Data inizio appello
08/08/2018;
Consultabilità
parziale
Data di rilascio
08/08/2021
Riassunto analitico
Aims: Idiopathic Pulmonary Fibrosis (IPF) has an unpredictable course and a staging system is still missing. We evaluated the role of radiological markers obtained with visual score and automatic quantitative analysis in predicting prognosis, clinical decline and progression in treated patients. <br>Materials and methods: we retrospectively selected 38 IPF patients with a baseline HRCT and pulmonary function tests (PFTs) available. HRCTs were evaluated by two radiologists using semi-quantitative visual score and automatic software (CALIPER). <br>Lung involvement was expressed as fibrosis score (FS) using visual score, and as interstitial lung disease score (ILD) and pulmonary vascular-related structure (PVRS) with CALIPER. <br>We evaluated radiological threshold predictive of 3-years mortality and short-term clinical decline. We analyzed clinical and radiological progression in 24 patients with serial CTs.<br>Results: Mortality rate was higher in patients with lower baseline values of FVC and DLCO (p = 0.012 and p = 0.004) and with higher baseline values of PVRS (p = 0.0001), ILD (p = 0.023) and FS (p = 0.016). Patients with PVRS ≥ 5%, ILD ≥ 18% and FS ≥ 30% had worse prognosis and more hospitalizations.<br>During follow-up, despite no significant decline of FVC, radiological markers showed significant progression (PVRS, p = 0.002; ILD, p = 0.011; FS, p = 0.003). Clinical and radiological progressions had significant correlations, the strongest between ILD and PVRS (p = &lt; 0.0001, r = 0.762).<br>Conclusion: IPF radiological markers are very promising tools to determine prognosis and progression in treated patients. They also specifically underlined subclinical disease progression.<br>
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