The University of Southampton
University of Southampton Institutional Repository

Idiopathic pulmonary fibrosis: CT and risk of death

Idiopathic pulmonary fibrosis: CT and risk of death
Idiopathic pulmonary fibrosis: CT and risk of death
Purpose To investigate the prognostic value of quantitative computed tomographic (CT) scoring for the extent of fibrosis or emphysema in the context of a clinical model that includes the gender, age, and physiology (GAP model) of the patient. Materials and Methods Study cohorts were approved by local institutional review boards, and all patients provided written consent. This was a retrospective cohort study that included 348 patients (246 men, 102 women; mean age, 69 years ± 9) with idiopathic pulmonary fibrosis from two institutions. Fibrosis and emphysema visual scores were independently determined by two radiologists. Models were based on competing risks regression for death and were evaluated by using the C index and reclassification improvement. Results The CT-GAP model (a modification of the original GAP model that replaces diffusion capacity of carbon monoxide with CT fibrosis score) had accuracy comparable to that of the original GAP model, with a C index of 70.3 (95% confidence interval: 66.4, 74.0); difference in C index compared with the GAP model of -0.4 (95% confidence interval: -2.2, 3.4). The performance of the original GAP model did not change significantly with the simple addition of fibrosis score, with a change in C index of 0.0 (95% confidence interval: -1.8, 0.5) or of emphysema score, with a change in C index of 0.0 [95% confidence interval: -1.3, 0.4]). Conclusion CT fibrosis score can replace diffusion capacity of carbon monoxide test results in a modified GAP model (the CT-GAP model) with comparable performance. This may be a useful alternative model in situations where CT scoring is more reliable and available than diffusion capacity of carbon monoxide. © RSNA, 2014 Online supplemental material is available for this article .
0033-8419
130216
Ley, Brett
ccaf50c6-cd5b-4d4e-bb21-2b7b2f578231
Elicker, Brett M.
0fd41517-e990-46ad-941f-ed0cd82af30d
Hartman, Thomas E.
6fa2ed5e-ce13-4c30-8f75-7cfcd789b332
Ryerson, Christopher J.
d7904e80-fa84-4514-95b3-4f24acbcce1f
Vittinghoff, Eric
cf35aee6-f3b1-456e-beec-79d7362b17f4
Ryu, Jay H.
a2049d37-c504-498b-a9ba-010ef7ef5b24
Lee, Joyce S.
76fedf8e-1be0-45b9-8f0c-14a4cd32273f
Jones, Kirk D.
22fb3000-abeb-4cb0-bf2f-4906230a76c0
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
King, Talmadge E.
4514ccf1-980f-4216-bfe9-26f6f3c96638
Collard, Harold R.
6eee2ce5-3016-4c13-ac58-f30a77f7d141
Ley, Brett
ccaf50c6-cd5b-4d4e-bb21-2b7b2f578231
Elicker, Brett M.
0fd41517-e990-46ad-941f-ed0cd82af30d
Hartman, Thomas E.
6fa2ed5e-ce13-4c30-8f75-7cfcd789b332
Ryerson, Christopher J.
d7904e80-fa84-4514-95b3-4f24acbcce1f
Vittinghoff, Eric
cf35aee6-f3b1-456e-beec-79d7362b17f4
Ryu, Jay H.
a2049d37-c504-498b-a9ba-010ef7ef5b24
Lee, Joyce S.
76fedf8e-1be0-45b9-8f0c-14a4cd32273f
Jones, Kirk D.
22fb3000-abeb-4cb0-bf2f-4906230a76c0
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
King, Talmadge E.
4514ccf1-980f-4216-bfe9-26f6f3c96638
Collard, Harold R.
6eee2ce5-3016-4c13-ac58-f30a77f7d141

Ley, Brett, Elicker, Brett M., Hartman, Thomas E., Ryerson, Christopher J., Vittinghoff, Eric, Ryu, Jay H., Lee, Joyce S., Jones, Kirk D., Richeldi, Luca, King, Talmadge E. and Collard, Harold R. (2014) Idiopathic pulmonary fibrosis: CT and risk of death. Radiology, 273 (2), 130216. (doi:10.1148/radiol.14130216). (PMID:24927326)

Record type: Article

Abstract

Purpose To investigate the prognostic value of quantitative computed tomographic (CT) scoring for the extent of fibrosis or emphysema in the context of a clinical model that includes the gender, age, and physiology (GAP model) of the patient. Materials and Methods Study cohorts were approved by local institutional review boards, and all patients provided written consent. This was a retrospective cohort study that included 348 patients (246 men, 102 women; mean age, 69 years ± 9) with idiopathic pulmonary fibrosis from two institutions. Fibrosis and emphysema visual scores were independently determined by two radiologists. Models were based on competing risks regression for death and were evaluated by using the C index and reclassification improvement. Results The CT-GAP model (a modification of the original GAP model that replaces diffusion capacity of carbon monoxide with CT fibrosis score) had accuracy comparable to that of the original GAP model, with a C index of 70.3 (95% confidence interval: 66.4, 74.0); difference in C index compared with the GAP model of -0.4 (95% confidence interval: -2.2, 3.4). The performance of the original GAP model did not change significantly with the simple addition of fibrosis score, with a change in C index of 0.0 (95% confidence interval: -1.8, 0.5) or of emphysema score, with a change in C index of 0.0 [95% confidence interval: -1.3, 0.4]). Conclusion CT fibrosis score can replace diffusion capacity of carbon monoxide test results in a modified GAP model (the CT-GAP model) with comparable performance. This may be a useful alternative model in situations where CT scoring is more reliable and available than diffusion capacity of carbon monoxide. © RSNA, 2014 Online supplemental material is available for this article .

Full text not available from this repository.

More information

Accepted/In Press date: 12 June 2014
e-pub ahead of print date: November 2014
Published date: November 2014
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 369053
URI: https://eprints.soton.ac.uk/id/eprint/369053
ISSN: 0033-8419
PURE UUID: 3ca1638e-1c76-4c9b-95c6-01bcc5a3f663

Catalogue record

Date deposited: 18 Sep 2014 15:57
Last modified: 15 Jul 2019 21:44

Export record

Altmetrics

Contributors

Author: Brett Ley
Author: Brett M. Elicker
Author: Thomas E. Hartman
Author: Christopher J. Ryerson
Author: Eric Vittinghoff
Author: Jay H. Ryu
Author: Joyce S. Lee
Author: Kirk D. Jones
Author: Luca Richeldi
Author: Talmadge E. King
Author: Harold R. Collard

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×