Chest
Original ResearchGenetic and Developmental DisordersAssessment of Early Bronchiectasis in Young Children With Cystic Fibrosis Is Dependent on Lung Volume
Section snippets
Study Population
This study included 40 consecutive subjects with CF aged 1 to 5 years who underwent a volumetric inspiratory and expiratory chest CT scan performed under general anesthesia while clinically stable as part of an early surveillance program approved by the local hospital ethics committee at Princess Margaret Hospital for Children in Australia (approval number 1762/EPP). These children were the first 40 children age 1 to 5 years to undergo paired inspiratory and expiratory volumetric chest CT scans
Semiquantitative CT Scores
Intraclass correlation coefficients for within-observer agreement for bronchiectasis were 0.79 (scorer 1) and 0.95 (scorer 2) for inspiratory scans and 0.94 (scorer 1) and 0.95 (scorer 2) for expiratory scans, and between-observer agreements were 0.78 for inspiratory scans and 0.92 for expiratory scans, indicating good to excellent agreement for these semiquantitative scores. The sensitivity, specificity, and positive and negative predictive values for the expiratory scans vs the inspiratory
Discussion
This study demonstrates that assessment of early bronchiectasis in infants and young children with CF by chest CT scan depends on lung volume, providing strong support for standardization of lung volume in studies evaluating airway dimensions by chest CT scan. With the use of limited-slice chest CT scan, Long et al4 demonstrated that end-inspiratory images obtained through a controlled ventilation technique are more sensitive to detect bronchiectasis than images obtained during quiet breathing
Acknowledgments
Author contributions: Dr Mott had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Mott: contributed to the study concept and design; data acquisition, analysis, and interpretation; statistical analysis; and preparation, revision, and final approval of the manuscript.
Dr Graniel: contributed to the data acquisition and revision and final approval of the manuscript.
Ms Park: contributed to the data
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Cited by (48)
Lung inflammation and simulated airway resistance in infants with cystic fibrosis
2021, Respiratory Physiology and NeurobiologyVentilation and perfusion assessed by functional MRI in children with CF: reproducibility in comparison to lung function
2019, Journal of Cystic FibrosisCitation Excerpt :However, lung function techniques do not directly assess the regional location or extent of structural and function impairment in the lung [12]. High-resolution computed tomography (HR-CT) or magnetic resonance imaging (MRI) scans can detect regional structural and functional changes in the lung [13–18]. The main advantage of functional MRI-based techniques is the lack of exposure to ionizing radiation [19–21].
Chest imaging in cystic fibrosis studies: What counts, and can be counted?
2017, Journal of Cystic FibrosisCitation Excerpt :In children of 6 years of age and above, lung volume can best be controlled for using a spirometer [40]. Participants below the age of 6 years may have difficulty following spirometer-based protocols; in these instances, general anesthesia and a pressure-controlled protocol can be used for lung volume control [22]. Children aged 3–6 years can be trained to execute a breath hold after taking a deep breath or at the FRC level.
Diagnosis and quantification of bronchiectasis using computed tomography or magnetic resonance imaging: A systematic review: Diagnostic criteria for bronchiectasis
2020, Respiratory MedicineCitation Excerpt :A total of 4182 papers were identified. After screening all titles and abstracts, 972 papers were selected for full text evaluation, and 122 were included in the analysis [5–126] Criteria for radiological diagnosis of bronchiectasis across 122 studies are reported in Table 3.
Profs Tiddens and Stick contributed equally to this manuscript as senior authors.
Part of this article has been presented in abstract form (Mott L, Gonzalez-Graniel K, Murray C, Sly P, Tiddens H, Stick S; AREST CF. Eur Respir J. 2011;38:848s and Mott L, Graniel K, Park J, et al; AREST CF. Respirology. 2012:17:56).
Funding/Support: The AREST CF research program is funded by the Cystic Fibrosis Foundation Therapeutics, Inc [Sly040A, Stick090A]; the Australian Cystic Fibrosis Research Trust; and the National Health and Medical Research Council [513730], Australia. Dr Mott was supported by a short-term research fellowship from the European Respiratory Society to travel to Rotterdam, The Netherlands, to commence this study and was supported in her PhD studies by the National Health and Medical Research Council, the University of Western Australia, the Cystic Fibrosis Association of Western Australia, and the Australian Cystic Fibrosis Research Trust. Dr Graniel was supported by a grant from The Nederlandse Cystic Fibrosis Stichting.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.
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The members of the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) can be found at www.arestcf.org.