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Idiopathic Nonspecific Interstitial Pneumonia: Changes in High-Resolution Computed Tomography on Long-Term Follow-Up

Kim, Mi-Young MD, PhD*; Song, Jin Woo MD; Do, Kyung-Hyun MD*; Jang, Se Jin MD; Colby, Thomas V. MD§; Kim, Dong Soon MD

Journal of Computer Assisted Tomography: March/April 2012 - Volume 36 - Issue 2 - p 170–174
doi: 10.1097/RCT.0b013e31823ed437
Thoracic Imaging

Objective This study aimed to assess the change in findings of nonspecific interstitial pneumonia (NSIP) from high-resolution computed tomography (HRCT) on long-term follow-up (median, 38 months).

Materials and Methods A retrospective review of changes in HRCT in 68 patients with NSIP (fibrotic progression, 61) with follow-up HRCT of at least 1-year interval was conducted.

Results Follow-up HRCT findings showed a decreased extent of ground-glass opacity and consolidation, with increased honeycombing, traction bronchiectasis, and architectural distortion (all P < 0.05). Radiological improvement was seen in 36%, stability was seen in 23%, and fibrotic progression was seen with recurrence in 13% and without recurrence in 28%. In 3 patients (4.9%), HRCT converted to a definite usual interstitial pneumonia pattern. Honeycombing and reticulation were independent predictors for mortality in fibrotic NSIP (P < 0.01).

Conclusions Although most of the follow-up HRCT scans showed improvement in the extent of ground-glass opacity and consolidation, approximately one third showed fibrotic progression or recurrence, with transition from NSIP to definite usual interstitial pneumonia pattern.

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From the Departments of *Radiology, †Pulmonary and Critical Care Medicine, and ‡Pathology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea; and §Department of Pathology, Mayo Clinic, Scottsdale, AZ.

Received for publication July 21, 2011; accepted October 25, 2011.

Reprints: Dong Soon Kim, MD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Pungnap-2dong, Songpa-gu, Seoul, South Korea (e-mail:

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2012 Lippincott Williams & Wilkins, Inc.