Imaging IDs Idiopathic Pulmonary Fibrosis Without Biopsy
(HealthDay News) — In patients suspected of having idiopathic pulmonary fibrosis but without typical patterns of lung damage on high-resolution computed tomography (CT), high-resolution CT can correctly diagnose the disease in most cases without the need for a lung biopsy, according to a study published online February 18 in The Lancet Respiratory Medicine.
Ganesh Raghu, MD, from the University of Washington in Seattle, and colleagues retrospectively examined the predictive value of high-resolution CT in 315 adults with well-defined idiopathic pulmonary fibrosis and five percent or less honeycombing (usual interstitial pneumonia) on high-resolution CT. The participants had both high-resolution CT and surgical lung biopsy samples.
The researchers found that 97.3% of 111 patients who met high-resolution CT criteria for usual interstitial pneumonia and 94.0% of 84 patients who met high-resolution CT criteria for possible usual interstitial pneumonia had histologically confirmed disease. In contrast, only 18.3% of 120 patients with an inconsistent high-resolution CT pattern were histologically confirmed as not having or possibly having usual interstitial pneumonia.
"In the appropriate clinical setting, for patients with possible usual interstitial pneumonia pattern on high resolution CT, surgical lung biopsy sampling might not be necessary to reach a diagnosis of idiopathic pulmonary fibrosis if high-resolution CT scans are assessed by experts at regional sites familiar with patterns of usual interstitial pneumonia and management of idiopathic interstitial pneumonia," Raghu and colleagues conclude.
The study was funded by Gilead Sciences. Several authors are employees of Gilead, Perceptive Informatics, or Cardeas Pharma, or have financial ties to Gilead.