Computed tomography correlates with pulmonary exacerbations in children with cystic fibrosis

被引:112
作者
Brody, AS
Sucharew, H
Campbell, JD
Millard, SP
Molina, PL
Klein, JS
Quan, J
机构
[1] Cincinnati Childrens Hosp, Dept Radiol, Cincinnati, OH 45229 USA
[2] Ctr Med, Cincinnati, OH USA
[3] Cyst Fibrosis Fdn Therapeut Dev Network Coordinat, Stat Anal Unit, Seattle, WA USA
[4] Univ N Carolina, Sch Med, Chapel Hill, NC USA
[5] Univ Vermont, Burlington, VT USA
[6] Genentech Inc, San Francisco, CA 94080 USA
关键词
children; computerized tomography X-ray; forced expiratory volume; pulmonary function tests; surrogate endpoint;
D O I
10.1164/rccm.200407-989OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Rationale: High-resolution computed tomography (HRCT) has been suggested as a potential outcome surrogate for cystic fibrosis (CF) lung disease. An important attribute of a valid outcome surrogate is that the surrogate reflects true clinical outcomes. Objectives: We performed this study to validate HRCT, a proposed surrogate outcome measure for CF lung disease, against a true clinical outcome, the number of respiratory tract exacerbations occurring in 2 yr, and to assess the correlation of CT scores and pulmonary function tests (PFTs) with this clinical outcome. Methods: CTs and PFTs were performed on 6- to 10-yr-old children at the beginning and end of a 2-yr study during which the number of exacerbations were recorded. Spearman correlations and Poisson models were used to assess the correlation of the number of exacerbations with baseline values and changes in PFTs and CT scores. Measurements and Main Results: Nine of 61 subjects had a total of 22 respiratory tract exacerbations. At baseline, PFTs and four CT scores showed significant correlation with number of exacerbations, but no variable by itself predicted exacerbations with high accuracy. For change over the 2-yr period, three CT scores showed significant correlation with exacerbations, whereas no PFTs showed significant correlation. Conclusion: This is the first study showing correlation between CT and a true clinical outcome. Change in CT scores correlates moderately well with the number of exacerbation. Poor correlation between change in FEV1 and exacerbations suggests that HRCT may be a more appropriate outcome surrogate for longitudinal studies of young children.
引用
收藏
页码:1128 / 1132
页数:5
相关论文
共 35 条
  • [21] MACLUSKY JLH, 1998, KENDIGS DISORDERS RE, P838
  • [22] Repeated adeno-associated virus serotype 2 aerosol-mediated cystic fibrosis transmembrane regulator gene transfer to the lungs of patients with cystic fibrosis - A multicenter, double-blind, placebo-controlled trial
    Moss, RB
    Rochman, D
    Spencer, LT
    Aitken, ML
    Zeitlhi, PL
    Waltz, D
    Milla, C
    Brody, AS
    Clancy, JP
    Ramsey, B
    Hamblett, N
    Heald, AE
    [J]. CHEST, 2004, 125 (02) : 509 - 521
  • [23] ULTRAFAST COMPUTERIZED-TOMOGRAPHY OF THE CHEST IN CYSTIC-FIBROSIS - A NEW SCORING SYSTEM
    NATHANSON, I
    CONBOY, K
    MURPHY, S
    AFSHANI, E
    KUHN, JP
    [J]. PEDIATRIC PULMONOLOGY, 1991, 11 (01) : 81 - 86
  • [24] *NIH, 1997, WORKSH SURR MARK CF
  • [25] A two-year randomized, placebo-controlled trial of dornase alfa in young patients with cystic fibrosis with mild lung function abnormalities
    Quan, JM
    Tiddens, HAWM
    Sy, JP
    McKenzie, SG
    Montgomery, MD
    Robinson, PJ
    Wohl, MEB
    Konstan, MW
    [J]. JOURNAL OF PEDIATRICS, 2001, 139 (06) : 813 - 820
  • [26] OUTCOME MEASURES FOR CLINICAL-TRIALS IN CYSTIC-FIBROSIS
    RAMSEY, BW
    BOAT, TF
    [J]. JOURNAL OF PEDIATRICS, 1994, 124 (02) : 177 - 192
  • [27] ROBINSON TEK, 2001, PEDIATR PULM, V22, P378
  • [28] Azithromycin in, patients with cystic fibrosis chronically infected with Pseudomonas aeruginosa -: A randomized controlled trial
    Saiman, L
    Marshall, BC
    Mayer-Hamblett, N
    Burns, JL
    Quittner, AL
    Cibene, DA
    Coquillette, S
    Fieberg, AY
    Accurso, FJ
    Campbel, PW
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (13): : 1749 - 1756
  • [29] High-resolution CT in the acute exacerbation of cystic fibrosis: Evaluation of acute findings, reversibility of those findings, and clinical correlation
    Shah, RM
    Sexauer, W
    Ostrum, BJ
    Fiel, SB
    Friedman, AC
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 1997, 169 (02) : 375 - 380
  • [30] Biomarkers in imaging: Realizing radiology's future
    Smith, JJ
    Sorensen, AG
    Thrall, JH
    [J]. RADIOLOGY, 2003, 227 (03) : 633 - 638