Thin-section CT characteristics and longitudinal CT follow-up of chemotherapy induced interstitial pneumonitis: A retrospective cohort study

Han Na Lee, Mi Young Kim, Hyun Jung Koo, Sung Soo Kim, Dok Hyun Yoon, Jae Cheol Lee, Jin Woo Song

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4 Scopus citations

Abstract

To describe the computed tomography (CT) features of chemotherapy-induced interstitial pneumonitis (CIIP) with longitudinal follow-up. The study was approved by the local ethics committee. One hundred consecutive patients with CIIP between May 2005 and March 2015 were retrospectively enrolled. The initial CT was reviewed by 2 independent chest radiologists and categorized into 1 of 4 CT patterns in accordance with the 2013 guidelines for idiopathic interstitial pneumonia: nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), hypersensitivity pneumonitis (HP) mimicking desquamative interstitial pneumonitis, and diffuse alveolar damage (DAD). We assessed semiquantitative analysis on a 5% scale to assess the extent of parenchymal abnormalities (emphysema, reticulation, ground-glass opacity, consolidation, honeycombing cyst) and their distribution on initial (n=100), subsequent (n=87), and second follow-up CT (n=48). Interval changes in extent on follow-up CT were compared using paired t test. The clinic-radiologic factors were compared between Group 1 (NSIP and OP patterns) and Group 2 (HP and DAD patterns) using x2 and independent t tests. The most common pattern of CIIP on the initial CT was HP (51%), followed by NSIP (23%), OP (20%), and DAD (6%). Diffuse groundglass opacity was the most common pulmonary abnormality. The predominant distribution was bilateral (99%) and symmetric (82%), with no craniocaudal (60%) or axial (79%) dominance. Subsequent and second follow-up CTs showed decreased extent of total pulmonary abnormalities (P<0.001, respectively). In comparison with Group 1 CIIP, Group 2 CIIP was more likely to be caused by molecularly targeted drugs (P=0.030), appeared earlier (P=0.034), and underwent more complete resolution (P<0.001). Use of a CT pattern-recognition approach to CIIP is appropriate and practical in interpreting radiological findings.

Original languageEnglish (US)
Article numbere2460
JournalMedicine (United States)
Volume95
Issue number2
DOIs
StatePublished - Jan 1 2016

Bibliographical note

Publisher Copyright:
Copyright © 2016 Wolters Kluwer Health, Inc.

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