Quantitative Evaluation of Fibrosis in IPF Patients: Meaning of Diffuse Pulmonary Ossification
Monica Palermo,
Francesco Tiralongo,
Giulio Distefano,
Ada Vancheri,
Mauro Giuffrè,
Fabio Pino,
Pietro Valerio Foti,
Gianluca Sambataro,
Carlo Vancheri,
Stefano Palmucci,
Antonio Basile
Affiliations
Monica Palermo
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Francesco Tiralongo
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Giulio Distefano
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Ada Vancheri
Regional Referral Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Mauro Giuffrè
Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy
Fabio Pino
Regional Referral Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Pietro Valerio Foti
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Gianluca Sambataro
Regional Referral Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Carlo Vancheri
Regional Referral Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Stefano Palmucci
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
Antonio Basile
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University—Hospital Policlinico “G. Rodolico—S. Marco”, University of Catania, 95123 Catania, Italy
To investigate the role of diffuse pulmonary ossification (DPO) in disease severity in a population of Idiopathic Pulmonary Fibrosis (IPF) patients. This retrospective study was carried out on 95 IPF patients—44 with DPO on high resolution computed tomography (HRCT) and 51 with no calcifications detected on HRCT. Pulmonary Function Tests (PFTs) acquired nearest to the HRCT were collected. Images were analyzed by two radiologists using a qualitative method, based on HRCT fibrosis visual score, and using a quantitative method, based on histogram-based analysis. The Spearman’s rank correlation coefficient was used to measure the strength and direction of the linear relationship between HRCT fibrosis score and PFTs; in addition, Spearman’s rank correlation coefficient was used to explore the relationships between HRCT fibrosis score and quantitative index and between quantitative indexes and PFTs. A weak correlation between HRCT fibrosis score and PFTs was proven (r =–0.014 and p = 0.9347 for FVC (Forced Vital Capacity), r = −0.379 and p = 0.0174 for DLCO (Carbon monoxide diffusing capacity)). We found a moderate negative correlation between HRCT fibrosis score and kurtosis (r = −0.448, p = 0.004272) and skewness (r = −0.463, p = 0.003019) and a weak positive correlation with High Attenuation Area (HAA)% (r = 0.362, p = 0.0235). Moreover, a moderate linear correlation between Quantitative Indexes and FVC (r = 0.577, p = 0.000051 for kurtosis and FVC, r = 0.598, p = 0.000023 for skewness and FVC, r = −0.519, p = 0.0000364 for HAA% and FVC) and between quantitative indexes and DLCO (r = 0.469, p = 0.001508 for kurtosis, and DLCO, r = 0.474, p = 0.001309 for skewness and DLCO, r = −0.412, p = 0.005996 for HAA% and DLCO) was revealed. To better investigate the influence of DPO in disease progression, a longitudinal evaluation should be performed.
