Serial high resolution CT in non-specific interstitial pneumonia: prognostic value of the initial pattern

Clin Radiol. 2005 Jan;60(1):96-104. doi: 10.1016/j.crad.2004.06.029.


Aim: To assess the relationship between initial CT pattern and serial changes in CT findings and pulmonary function tests (PFTs) in patients with non-specific interstitial pneumonia (NSIP).

Materials and methods: Serial high resolution (HR) CTs and PFTs were retrospectively analyzed in 38 cases of histologically proven NSIP, including 4 with cellular NSIP, 13 with mixed cellular and fibrotic NSIP, and 21 with fibrotic NSIP. The presence and extent of various CT findings were assessed. A fibrosis index (defined as the ratio of the extent of a reticular/honeycomb pattern to the overall extent of abnormal parenchyma) was derived.

Results: The predominant CT pattern was reticular/honeycomb in 27 (84%) cases and ground-glass/consolidation in 6 (16%) cases. Between scans, mean disease extent reduced by 5.2%. Disease extent reduced by >10% in 13 (34%) and increased by >10% in 6 (16%) patients. Histopathological subtype of NSIP did not correlate with individual CT pattern, predominant pattern, fibrosis index or serial change in disease extent on CT or PFTs. Response on follow-up CT was associated with fibrosis index, predominant pattern and extent of consolidation on initial CT.

Conclusion: In NSIP disease, progression on CT correlates with the predominant CT pattern, fibrosis index, and extent of consolidation but not with histopathological subtype. An inflammatory (ground-glass/consolidation) predominant pattern is associated with better outcome in terms of disease extent on HRCT.

Publication types

  • Multicenter Study

MeSH terms

  • Disease Progression
  • Female
  • Humans
  • Lung Diseases, Interstitial / diagnostic imaging*
  • Lung Diseases, Interstitial / pathology
  • Male
  • Middle Aged
  • Observer Variation
  • Positron-Emission Tomography
  • Prognosis
  • Respiratory Function Tests
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*