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Nonspecific Interstitial Pneumonia: Prognostic Significance of High-Resolution Computed Tomography in 59 Patients

Hozumi, Hironao MD; Nakamura, Yutaro MD, PhD; Johkoh, Takeshi MD, PhD; Sumikawa, Hiromitsu MD, PhD; Colby, Thomas V. MD, PhD; Karayama, Masato MD; Hayakawa, Hiroshi MD, PhD; Yokomura, Koushi MD, PhD; Imokawa, Shiro MD, PhD; Yasuda, Kazumasa MD, PhD; Toyoshima, Mikio MD, PhD; Suganuma, Hideki MD, PhD; Shirai, Toshihiro MD, PhD; Inui, Naoki MD, PhD; Suda, Takafumi MD, PhD; Nakamura, Hirotoshi MD, PhD; Chida, Kingo MD, PhD

Journal of Computer Assisted Tomography: September/October 2011 - Volume 35 - Issue 5 - pp 583-589
doi: 10.1097/RCT.0b013e31822a5883
Thoracic Imaging

Objective: To retrospectively analyze the prognostic implications of high-resolution computed tomography (HRCT) findings for patients with biopsy-proven nonspecific interstitial pneumonia (NSIP).

Methods: Fifty-nine patients with NSIP (25 idiopathic NSIP, 34 collagen-vascular disease-associated NSIP) were included. Two chest radiologists independently evaluated the extent, presence, and distribution of various HRCT findings. Cox hazards analysis was used to evaluate the relationship between HRCT findings and prognosis.

Results: The 5-year survival rate was 83% and the 10-year survival rate was 66%. Univariate analysis revealed that the extent of areas with ground-glass attenuation without traction bronchi-bronchiolectasis and that of airs-pace consolidation were associated with favorable outcome, whereas that of intralobular reticular opacities was associated with worse prognosis. Multivariate analysis showed that the extent of air-space consolidation was an independent factor of favorable outcome.

Conclusion: In NSIP, the extent of areas with ground-glass attenuation without traction bronchi-bronchiolectasis, air-space consolidation, and intralobular reticular opacities correlate with survival.

From *The Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama Higashiku, Hamamatsu, Japan; †Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Itami City, Hyogo, Japan; ‡Department of Radiology, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan; and §Department of Pathology, Mayo Clinic Arizona, Scottsdale, AZ.

Received for publication April 28, 2011; accepted June 21, 2011.

Reprints: Yutaro Nakamura, MD, PhD, The Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, 431-3192, Japan (e-mail: nakayuta@hama-med.ac.jp).

This study was partly supported by a grant to the Diffuse Lung Diseases Research Group from the Ministry of Health, Labour and Welfare, Japan.

All authors do not have any personal or financial support or involvement with organization(s) that have financial interest in the subject matter, or any conflicts of interest.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.