PT  - JOURNAL ARTICLE
AU  - C M Owens
AU  - P Aurora
AU  - S Stanojevic
AU  - A Bush
AU  - A Wade
AU  - C Oliver
AU  - A Calder
AU  - J Price
AU  - S B Carr
AU  - A Shankar
AU  - Janet Stocks
TI  - Lung Clearance Index and HRCT are complementary markers of lung abnormalities in young children with CF
AID  - 10.1136/thx.2010.150375
DP  - 2011 Jun 01
TA  - Thorax
PG  - 481--488
VI  - 66
IP  - 6
4099  - http://thorax.bmj.com/content/66/6/481.short
4100  - http://thorax.bmj.com/content/66/6/481.full
SO  - Thorax2011 Jun 01; 66
AB  - Rationale High resolution computed tomography (HRCT) is a more sensitive tool for detecting early cystic fibrosis (CF) lung disease than either spirometry or plain radiography, but its relationship to other measures of lung function has not been established in young children.Objectives 1) To assess whether the lung clearance index (LCI) derived from multiple breath inert-gas washout (MBW) is as effective as HRCT in identifying pulmonary abnormalities; and 2) explore the relationships between abnormalities detected by HRCT and by spirometry, plethysmography and MBW (collectively, LFTs) in young children with CF.Methods Children with CF underwent LFTs and volumetric HRCT on the same day. Healthy age-matched controls underwent identical LFTs without HRCT. Scans were anonymised, and scored using the Brody-II CT scoring system, to assess for presence and extent of bronchiectasis, airway wall thickening, mucus plugging, and parenchymal opacities.Results Assessments were undertaken in 60 children with CF (mean (SD) 7.8 (1.3) years) and 54 healthy controls (7.9 (1.2) y). Among children with CF, 84% (47/56) had abnormal LCI, 58% (27/47) abnormal plethysmographic lung volumes (FRCpleth or RV), 35% (21/60) abnormal sRaw and 47% (28/60) abnormal spirometry (FEV1 or FEF25–75); whereas HRCT scans were abnormal in 85% (51/60): median total Brody-II score: 9.5% (range 0–51%). Total CT score correlated more strongly with LCI (Spearman correlation=0.77) than with spirometry (R=−0.43) or any other marker of lung function. Of the nine children with normal LCI, five had abnormalities on HRCT, whereas five children with normal HRCT had raised LCI.Conclusions These results suggest that while LCI and HRCT have similar sensitivity to detect CF lung disease, complimentary information may be gained in individual patients.