Imperial College London
Alternate

PROFESSOR DAVID HANSELL

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Thoracic Imaging
 
 
 
//

Contact

 

d.m.hansell Website

 
 
//

Location

 

RadiologySouth BlockRoyal Brompton Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Jacob:2017:10.1183/13993003.00379-2017,
author = {Jacob, J and Bartholmai, BJ and Rajagopalan, S and Kokosi, M and Maher, TM and Nair, A and Karwoski, R and Renzoni, E and Walsh, SLF and Hansell, DM and Wells, AU},
doi = {10.1183/13993003.00379-2017},
journal = {European Respiratory Journal},
title = {Functional and prognostic effects when emphysema complicates idiopathic pulmonary fibrosis},
url = {http://dx.doi.org/10.1183/13993003.00379-2017},
volume = {50},
year = {2017}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - This study aimed to investigate whether the combination of fibrosis and emphysema has a greater effect than the sum of its parts on functional indices and outcome in idiopathic pulmonary fibrosis (IPF), using visual and computer-based (CALIPER) computed tomography (CT) analysis.Consecutive patients (n=272) with a multidisciplinary IPF diagnosis had the extent of interstitial lung disease (ILD) scored visually and by CALIPER. Visually scored emphysema was subcategorised as isolated or mixed with fibrotic lung. The CT scores were evaluated against functional indices forced vital capacity (FVC), diffusing capacity of the lungs for carbon monoxide (DLCO), transfer coefficient of the lung for carbon monoxide (KCO), composite physiologic index (CPI)) and mortality.The presence and extent of emphysema had no impact on survival. Results were maintained following correction for age, gender, smoking status and baseline severity using DLCO, and combined visual emphysema and ILD extent. Visual emphysema quantitation indicated that relative preservation of lung volumes (FVC) resulted from tractionally dilated airways within fibrotic lung, ventilating areas of admixed emphysema (p<0.0001), with no independent effect on FVC from isolated emphysema. Conversely, only isolated emphysema (p<0.0001) reduced gas transfer (DLCO).There is no prognostic impact of emphysema in IPF, beyond that explained by the additive extents of both fibrosis and emphysema. With respect to the location of pulmonary fibrosis, emphysema distribution determines the functional effects of emphysema.
AU  - Jacob,J
AU  - Bartholmai,BJ
AU  - Rajagopalan,S
AU  - Kokosi,M
AU  - Maher,TM
AU  - Nair,A
AU  - Karwoski,R
AU  - Renzoni,E
AU  - Walsh,SLF
AU  - Hansell,DM
AU  - Wells,AU
DO  - 10.1183/13993003.00379-2017
PY  - 2017///
SN  - 0903-1936
TI  - Functional and prognostic effects when emphysema complicates idiopathic pulmonary fibrosis
T2  - European Respiratory Journal
UR  - http://dx.doi.org/10.1183/13993003.00379-2017
VL  - 50
ER  -
Download