Advertisement

Congruence Between Pulmonary Function and Computed Tomography Imaging Assessment of Cystic Fibrosis Severity

  • Anna Rybacka
  • Joanna Goździk-Spychalska
  • Adam Rybacki
  • Tomasz Piorunek
  • Halina Batura-Gabryel
  • Katarzyna Karmelita-Katulska
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1114)

Abstract

In cystic fibrosis, pulmonary function tests (PFTs) and computed tomography are used to assess lung function and structure, respectively. Although both techniques of assessment are congruent there are lingering doubts about which PFTs variables show the best congruence with computed tomography scoring. In this study we addressed the issue by reinvestigating the association between PFTs variables and the score of changes seen in computed tomography scans in patients with cystic fibrosis with and without pulmonary exacerbation. This retrospective study comprised 40 patients in whom PFTs and computed tomography were performed no longer than 3 weeks apart. Images (inspiratory: 0.625 mm slice thickness, 0.625 mm interval; expiratory: 1.250 mm slice thickness, 10 mm interval) were evaluated with the Bhalla scoring system. The most frequent structural abnormality found in scans were bronchiectases and peribronchial thickening. The strongest relationship was found between the Bhalla sore and forced expiratory volume in 1 s (FEV1). The Bhalla sore also was related to forced vital capacity (FVC), FEV1/FVC ratio, residual volume (RV), and RV/total lung capacity (TLC) ratio. We conclude that lung structural data obtained from the computed tomography examination are highly congruent to lung function data. Thus, computed tomography imaging may supersede functional assessment in cases of poor compliance with spirometry procedures in the lederly or children. Computed tomography also seems more sensitive than PFTs in the assessment of cystic fibrosis progression. Moreover, in early phases of cystic fibrosis, computed tomography, due to its excellent resolution, may be irreplaceable in monitoring pulmonary damage.

Keywords

Bhalla scoring system Bronchiectases Computed tomography Cystic fibrosis Lung imaging Pulmonary function tests 

Notes

Conflicts of interest

The authors declare no conflicts of interest in relation to this article.

References

  1. Abbott GF, Rosado-de-Christenson ML, Rossi SE, Suster S (2009) Imaging of small airways disease. J Thorac Imaging 24:285–298CrossRefPubMedGoogle Scholar
  2. Austin JH, Muller NL, Friedman PJ, Hansell DM, Naidich DP, Remy-Jardin M, Webb WR, Zerhouni EA (1996) Glossary of terms for CT of the lungs: recommendations of the nomenclature Committee of the Fleischner Society. Radiology 200:327–331CrossRefPubMedGoogle Scholar
  3. Bhalla M, Turcios N, Aponte V, Jenkins M, Leitman BS, McCauley DI, Naidich DP (1991) Cystic fibrosis: scoring system with thin section computed tomography. Radiology 179:783–788CrossRefPubMedGoogle Scholar
  4. Bonavita J, Naidich DP (2012) Imaging of bronchiectases. Clin Chest Med 33:233–248CrossRefPubMedGoogle Scholar
  5. Brody AS, Klein JS, Molina PL, Quan J, Bean JA, Wilmott RW (2004) High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. J Pediatr 145:32–38CrossRefPubMedGoogle Scholar
  6. Davies JC, Alton EW (2009) Monitoring respiratory disease severity in cystic fibrosis. Respir Care 54:606–617CrossRefPubMedGoogle Scholar
  7. Davis PB, Drumm M, Konstan MW (1996) Cystic fibrosis. Am J Respir Crit Care Med 154:1229–1256CrossRefPubMedGoogle Scholar
  8. de Jong PA, Nakano Y, Lequin MH, Mayo JR, Woods R, Paré PD, Tiddens HA (2004a) Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis. Eur Respir J 23:93–97CrossRefPubMedGoogle Scholar
  9. de Jong PA, Ottink MD, Robben SG, Lequin MH, Hop WC, Hendriks JJ, Paré PD, Tiddens HA (2004b) Pulmonary disease assessment in cystic fibrosis: comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 231:434–439CrossRefPubMedGoogle Scholar
  10. de Jong PA, Nakano Y, Hop WC, Long FR, Coxson HO, Paré PD, Tiddens HA (2005) Changes in airway dimensions on computed tomography scans of children with cystic fibrosis. Am J Respir Crit Care Med 172:218–224CrossRefPubMedGoogle Scholar
  11. de Jong PA, Lindblad A, Rubin L, Hop WC, de Jongste JC, Brink M, Tiddens HA (2006) Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis. Thorax 61:80–85CrossRefPubMedGoogle Scholar
  12. Demirkazık FB, Arıyürek OM, Özçelik U, Gocmen A, Hassanabad HK, Kiper N (2001) High resolution CT in children with cystic fibrosis: correlation with pulmonary functions and radiographic scores. Eur J Radiol 37:54–59CrossRefPubMedGoogle Scholar
  13. Duncan JA, Aurora P (2014) Monitoring early lung disease in cystic fibrosis: where are we now? Breathe 10:34–47CrossRefGoogle Scholar
  14. Helbich TH, Heinz-Peer G, Eichler I, Wunderbaldinger P, Götz M, Wojnarowski C, Brasch RC, Herold CJ (1999) Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology 213:537–544CrossRefPubMedGoogle Scholar
  15. Judge EP, Dodd JD, Masterson JB, Gallagher CG (2006) Pulmonary abnormalities on high-resolution CT demonstrate more rapid decline than FEV1 in adults with cystic fibrosis. Chest 130:1424–1432CrossRefPubMedGoogle Scholar
  16. Kerem E, Reisman J, Corey M, Canny GJ, Levison H (1992) Prediction of mortality in patients with cystic fibrosis. N Engl J Med 326:1187–1191CrossRefPubMedGoogle Scholar
  17. Kuo W, Kemner-van de Corput MP, Perez-Rovira A, de Bruijne M, Fajac I, Tiddens HA (2016) Multicentre chest computed tomography standardisation in children and adolescents with cystic fibrosis: the way forward. Eur Respir J 47:1706–1717CrossRefPubMedGoogle Scholar
  18. Maffessanti M, Candusso M, Brizzi F, Piovesana F (1996) Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging 11:27–38CrossRefPubMedGoogle Scholar
  19. Marchant JM, Masel JP, Dickinson FL, Masters IB, Chang AB (2001) Application of chest high-resolution computer tomography in young children with cystic fibrosis. Pediatr Pulmonol 3:24–29CrossRefGoogle Scholar
  20. Montaudon M, Berger P, Cangini-Sacher A, de Dietrich G, Tunon- de-Lara JM, Marthan R, Laurent F (2007) Bronchial measurement with three-dimensional quantitative thin-section CT in patients with cystic fibrosis. Radiology 242:573–581CrossRefPubMedGoogle Scholar
  21. Murphy KP, Maher MM, O’Connor OJ (2016) Imaging of cystic fibrosis and pediatric bronchiectasis. AJR Am J Roentgenol 206:448–454CrossRefPubMedGoogle Scholar
  22. Ong T, Ramsey BW (2015) Update in cystic fibrosis 2014. Am J Respir Crit Care Med 192:669–675CrossRefPubMedGoogle Scholar
  23. Pereira FF, Ibiapina Cda C, Alvim CG, Camargos PA, Figueiredo R, Pedrosa JF (2014) Correlation between Bhalla score and spirometry in children and adolescents with cystic fibrosis. Rev Assoc Med Bras 60:216–221CrossRefPubMedGoogle Scholar
  24. Pittman JE (2015) Assessment and detection of early lung disease in cystic fibrosis. Pediatr Allergy Immunol Pulmonol 28:212–219CrossRefGoogle Scholar
  25. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows report working party standardization of lung function tests, European community for steel and coal official statement of the European respiratory society. Eur Respir J 16(Suppl):5–40CrossRefGoogle Scholar
  26. Ramsey BW, Boat TF (1994) Outcome measures for clinical trials in cystic fibrosis: summary of a cystic fibrosis foundation consensus conference. J Pediatr 124:177–192CrossRefPubMedGoogle Scholar
  27. Robinson TE, Leung AN, Northway WH, Blankenberg FG, Bloch DA, Oehlert JW, Al-Dabbagh H, Hubli S, Moss RB (2001) Spirometer-triggered high-resolution computed tomography and pulmonary function measurements during an acute exacerbation in patients with cystic fibrosis. J Pediatr 138:553–559CrossRefPubMedGoogle Scholar
  28. Santos MK, Cruvinel DL, de Menezes MB, Teixeira SR, Vianna EO, Jorge Elias JJ, Martinez JA (2016) Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity. Radiol Bras 49:351–357CrossRefPubMedPubMedCentralGoogle Scholar
  29. Shah RM, Sexauer W, Ostrum BJ, Fiel SB, Friedman AC (1997) High-resolution CT in the acute exacerbation of cystic fibrosis: evaluation of acute findings, reversibility of those findings, and clinical correlation. AJR Am J Roentgenol 169:375–380CrossRefPubMedGoogle Scholar
  30. Tepper LA, Ciet P, Caudri D, Quitter AL, Utens EM, Tiddens HA (2016) Validating chest MRI to detect and monitor cystic fibrosis lung disease in a pediatric cohort. Pediatr Pulmonol 51:34–41CrossRefPubMedGoogle Scholar
  31. Walkup LL, Woods JC (2015) Advances in imaging cystic fibrosis lung disease. Pediatr Allergy Immunol Pulmonol 28:220–229CrossRefGoogle Scholar
  32. Wielpütz MO, Eichinger M, Biederer J, Wege S, Stahl M, Sommerburg O, Mall MA, Kauczor HU, Puderbach M (2016) Imaging of cystic fibrosis lung disease and clinical interpretation. Rofo 188:834–845CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Anna Rybacka
    • 1
  • Joanna Goździk-Spychalska
    • 2
  • Adam Rybacki
    • 2
  • Tomasz Piorunek
    • 2
  • Halina Batura-Gabryel
    • 2
  • Katarzyna Karmelita-Katulska
    • 3
  1. 1.Department of Diagnostic ImagingUniversity Hospital of Lord’s TransfigurationPoznanPoland
  2. 2.Department of Pulmunology, Allergology and Respiratory OncologyPoznan University of Medical SciencesPoznanPoland
  3. 3.Department of General RadiologyUniversity of Medical SciencesPoznanPoland

Personalised recommendations