4.5 Review

Correlation of computed tomography findings and lung function in children and adolescents with cystic fibrosis

Journal

WORLD JOURNAL OF PEDIATRICS
Volume 17, Issue 3, Pages 221-226

Publisher

ZHEJIANG UNIV PRESS
DOI: 10.1007/s12519-020-00388-8

Keywords

Computed tomography; Computed tomography score; Cystic fibrosis; Lung clearance index; Lung function; Spirometry

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Most studies have shown moderate correlations between forced expiratory volume in the first second (FEV1) and other spirometric indices with CT structural lung damage. However, there are patients with normal FEV1 but abnormal CT and vice versa at an individual level. Longitudinal studies indicate that deterioration of structural lung damage does not occur in parallel with lung function progression, and lung clearance index is a better predictor of CT findings.
Background The timely and appropriate monitoring of pulmonary status is of utmost importance for patients with cystic fibrosis (CF). Computed tomography (CT) has been used in clinical and research settings for tracking lung involvement in CF patients. However, as CT delivers a considerable amount of radiation, its sequential use in CF patients remains a concern. The application of CT, therefore, should take into account its potential risks. This review aims to understand whether and to what extent the CT findings correlate with the findings from other monitoring tools in CF lung disease. Data sources PubMed was searched for articles about the correlation of chest CT findings with spirometric indices and with lung clearance index in children and adolescents with CF. The most relevant articles were reviewed and are presented herein. Results Most studies have shown that forced expiratory volume in the first second (FEV1) and other spirometric indices correlate moderately with CT structural lung damage. However, at the individual level, there were patients with FEV1 within the normal range and abnormal CT and vice versa. Furthermore, longitudinal studies have indicated that the deterioration of structural lung damage does not occur in parallel with the progression of lung function. Lung clearance index is a better predictor of CT findings. Conclusions In general, the existing studies do not support the use of lung function tests as surrogates of chest CT.

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