Lung Ultrasound in the Follow-up of Stable Idiopathic Pulmonary Fibrosis

Year 2022, Volume: 39 Issue: 4, 1190 - 1193, 29.10.2022

Oya Baydar Toprak Ezgi Özyılmaz İsmail Hanta Sedat Kuleci Efraim Güzel

Abstract

Aim: Idiopathic pulmonary fibrosis is the most common and severe form of idiopathic interstitial pneumonia and is responsible for 20% of interstitial lung disease (ILD) cases. In this study, it was planned to evaluate the relationship of these two methods in detecting lung changes in IPF using a 12-zone lung ultrasound protocol with the current standard evaluation method, high-resolution computed tomography.
Method: 22 patients diagnosed with idiopathic pulmonary fibrosis by multidisciplinary evaluation were included in the study and HRCT and pulmonary functional tests and LUS protocol of 12 lung regions were used.
Results: The mean age ± SD of the patients was 69.0 ± 7.59 years. 21 (95.5%) were male. While 17 (77.3%) of the patients included in the study were diagnosed with radiological evidence, the diagnosis of the rest was confirmed histopathologically. While 5 of the patients (22.7%) did not receive any special treatment, 13 of the remaining patients were taking pirfenidone and 4 were taking nintedanib. When the HRCT total fibrotic score was evaluated with the total LUS score, a correlation coefficient of 0.702 (P:0.000) was obtained.
Conclusion: In stable idiopathic pulmonary fibrosis, lung ultrasonography can be a readily accessible, non-irradiating, short-term, and rapidly informative monitoring technique that can be utilized at the bedside or during consultation instead of high reolution thorax computerized tomography.

Keywords

idiopathic pulmonary fibrosis, lung ultrasound, thorax tomography, pulmonary funcyion tests, gap

References

• 1- Devaraj A. Imaging: how to recognise idiopathic pulmonary fibrosis. Eur Respir Rev. 2014;23(132):215-219. doi:10.1183/09059180.00001514
• 2- European Commission, Directorate-General for Energy, Chateil, J. et al. Referral guidelines for medical imaging : availability and use in the European Union, Publications Office, 2014, https://data.europa.eu/doi/10.2833/18118
• 3- Manolescu D, Davidescu L, Traila D, Oancea C, Tudorache V. The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis. Clin Interv Aging. 2018;13:437-449. Published 2018 Mar 22. doi:10.2147/CIA.S156615
• 4- Lichtenstein D, Hulot JS, Rabiller A, Tostivint I, Mezière G. Feasibility and safety of ultrasound-aided thoracentesis in mechanically ventilated patients. Intensive Care Med. 1999;25(9):955-958. doi:10.1007/s001340050988
• 5- Gargani L, Doveri M, D'Errico L, et al. Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis. Rheumatology (Oxford). 2009;48(11):1382-1387. doi:10.1093/rheumatology/kep263
• 6- Sperandeo M, Varriale A, Sperandeo G, et al. Transthoracic ultrasound in the evaluation of pulmonary fibrosis: our experience. Ultrasound Med Biol. 2009;35(5):723-729. doi:10.1016/j.ultrasmedbio.2008.10.009
• 7- Sperandeo M, De Cata A, Molinaro F, et al. Ultrasound signs of pulmonary fibrosis in systemic sclerosis as timely indicators for chest computed tomography. Scand J Rheumatol. 2015;44(5):389-398. doi:10.3109/03009742.2015.1011228
• 8- Hansell DM, Bankier AA, MacMahon H et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246(3):697-722. doi:10.1148/radiol.2462070712
• 9- Kazerooni EA, Martinez FJ, Flint A, et al. Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring. AJR Am J Roentgenol. 1997;169(4):977-983. doi:10.2214/ajr.169.4.9308447
• 10- Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;198(5):e44-e68. doi:10.1164/rccm.201807-1255ST
• 11- Ranu H, Wilde M, Madden B. Pulmonary function tests. Ulster Med J. 2011;80(2):84-90.
• 12- Graham BL, Steenbruggen I, Miller MR, et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200(8):e70-e88. doi:10.1164/rccm.201908-1590ST
• 13- Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183(6):788-824. doi:10.1164/rccm.2009-040GL
• 14- Tomassetti S, Gurioli C, Ryu JH, et al. The impact of lung cancer on survival of idiopathic pulmonary fibrosis. Chest. 2015;147(1):157-164. doi:10.1378/chest.14-0359
• 15- Hasan AA, Makhlouf HA. B-lines: Transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases. Ann Thorac Med. 2014;9(2):99-103. doi:10.4103/1817-1737.128856