PMID- 28350485 OWN - NLM STAT- MEDLINE DCOM- 20170828 LR - 20200225 IS - 1546-3141 (Electronic) IS - 0361-803X (Print) IS - 0361-803X (Linking) VI - 208 IP - 6 DP - 2017 Jun TI - CT Findings, Radiologic-Pathologic Correlation, and Imaging Predictors of Survival for Patients With Interstitial Pneumonia With Autoimmune Features. PG - 1229-1236 LID - 10.2214/AJR.16.17121 [doi] AB - OBJECTIVE: The objective of this study is to determine the CT findings and patterns of interstitial pneumonia with autoimmune features (IPAF) and to assess whether imaging can predict survival for patients with IPAF. MATERIALS AND METHODS: The study included 136 subjects who met the criteria for IPAF and had diagnostic-quality chest CT scans obtained from 2006 to 2015; a total of 74 of these subjects had pathologic samples available for review within 1 year of chest CT examination. CT findings and the presence of an usual interstitial pneumonitis (UIP) pattern of disease were assessed, as was the UIP pattern noted on pathologic analysis. Analysis of chest CT findings associated with survival was performed using standard univariate and multivariate Cox proportional hazards methods as well as the unadjusted log-rank test. Survival data were visually presented using the Kaplan-Meier survival curve estimator. RESULTS: Most subjects with IPAF (57.4%; 78/136) had a high-confidence diagnosis of a UIP pattern on CT. Substantially fewer subjects (28.7%; 39/136) had a pattern that was inconsistent with UIP noted on CT. The presence of a UIP pattern on CT was associated with smoking (p < 0.01), male sex (p < 0.01), and older age (p < 0.001). Approximately one-fourth of the subjects had a nonspecific interstitial pneumonitis pattern on CT. Of interest, nearly one-tenth of the subjects had a CT pattern that was most consistent with hypersensitivity pneumonitis rather than the customary CT patterns ascribed to lung disease resulting from connective tissue disease. Most subjects with a possible UIP pattern on CT (83.3%) had UIP diagnosed on the basis of pathologic findings. Focused multivariate analysis showed that honeycombing on CT (hazard ratio, 2.17; 95% CI, 1.05-4.47) and pulmonary artery enlargement on CT (hazard ratio, 2.08; 95% CI, 1.02-4.20) were independent predictors of survival. CONCLUSION: IPAF most often presents with a UIP pattern on CT and is associated with worse survival when concomitant honeycombing or pulmonary artery enlargement is present. FAU - Chung, Jonathan H AU - Chung JH AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Montner, Steven M AU - Montner SM AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Adegunsoye, Ayodeji AU - Adegunsoye A AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Lee, Cathryn AU - Lee C AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Oldham, Justin M AU - Oldham JM AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Husain, Aliya N AU - Husain AN AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - MacMahon, Heber AU - MacMahon H AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Noth, Imre AU - Noth I AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Vij, Rekha AU - Vij R AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. FAU - Strek, Mary E AU - Strek ME AD - 1 Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. AD - 2 Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL. AD - 3 Section of Pulmonary/Critical Care, Department of Medicine, University of California at Davis, Sacramento, CA. AD - 4 Department of Pathology, University of Chicago Medical Center, Chicago, IL. LA - eng GR - T32 HL007605/HL/NHLBI NIH HHS/United States PT - Journal Article DEP - 20170328 PL - United States TA - AJR Am J Roentgenol JT - AJR. American journal of roentgenology JID - 7708173 SB - IM MH - Autoimmune Diseases/*diagnostic imaging/*mortality/pathology MH - Chicago/epidemiology MH - Comorbidity MH - Female MH - Humans MH - Lung Diseases, Interstitial/*diagnostic imaging/*mortality/pathology MH - Male MH - Middle Aged MH - Observer Variation MH - Prevalence MH - Prognosis MH - Reproducibility of Results MH - Retrospective Studies MH - Risk Assessment MH - Sensitivity and Specificity MH - Statistics as Topic MH - *Survival Analysis MH - Tomography, X-Ray Computed/*statistics & numerical data PMC - PMC6536259 MID - NIHMS976815 OTO - NOTNLM OT - CT OT - connective tissue disease OT - interstitial pneumonia with autoimmune features OT - survival OT - usual interstitial pneumonitis EDAT- 2017/03/30 06:00 MHDA- 2017/08/29 06:00 PMCR- 2019/05/27 CRDT- 2017/03/29 06:00 PHST- 2017/03/30 06:00 [pubmed] PHST- 2017/08/29 06:00 [medline] PHST- 2017/03/29 06:00 [entrez] PHST- 2019/05/27 00:00 [pmc-release] AID - 10.2214/AJR.16.17121 [doi] PST - ppublish SO - AJR Am J Roentgenol. 2017 Jun;208(6):1229-1236. doi: 10.2214/AJR.16.17121. Epub 2017 Mar 28.