PT  - JOURNAL ARTICLE
AU  - Kendrick, YK
AU  - Repapi, E
AU  - Helm, E
AU  - Cole, SL
AU  - Hoyles, R
AU  - Benamore, R
AU  - Ho, LP
TI  - P39 CTAS – a ct score to quantify disease activity in pulmonary sarcoidosis
AID  - 10.1136/thoraxjnl-2016-209333.182
DP  - 2016 Dec 01
TA  - Thorax
PG  - A103--A103
VI  - 71
IP  - Suppl 3
4099  - http://thorax.bmj.com/content/71/Suppl_3/A103.2.short
4100  - http://thorax.bmj.com/content/71/Suppl_3/A103.2.full
SO  - Thorax2016 Dec 01; 71
AB  - Introduction A major gap in the management of sarcoidosis is the lack of accessible and objective methods to measure disease activity. Since 90% of patients have pulmonary involvement, we explored if a disease activity score based on thoracic CT scan could address this clinical issue.Methods High resolution CT scans from 100 consecutive sarcoidosis patients at a regional sarcoidosis service were scored for extent of CT abnormalities known to relate to granuloma or lymphocytic infiltration from published CT-pathological studies. These individual abnormality scores were then correlated against serum ACE, sIL-2R and change in forced vital capacity (FVC) to identify CT abnormalities that reflect contemporaneous disease activity. The sum of these scores, or CT Activity Score (CTAS) was then validated against FVC response to treatment.Results and discussion CT extent scores for nodularity, ground-glass opacification, inter-lobular septal thickening and consolidation correlated significantly with at least one of the disease activity parameters and were used to form CTAS. CTAS was found to predict FVC response to treatment at one year and was highly reproducible between radiologists. An abbreviated CTAS (aCTAS), constructed from presence or absence of the four CT abnormalities also showed significant correlation with FVC response to treatment. CTAS and aCTAS also correlated with response to treatment in the fibrotic subgroup.Conclusions CTAS provides a concept for an objective and reproducible CT scoring method to quantify disease activity in sarcoidosis. The score can potentially be used to stratify patients according to disease activity, determine response to treatment and establish if fibrotic sarcoidosis is active.