TY - JOUR T1 - HRCT in the evaluation of functional decay in IPF JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA792 VL - 48 IS - suppl 60 SP - PA792 AU - Elisabetta Cocconcelli AU - Giulio Barbiero AU - Paolo Spagnolo AU - Graziella Turato AU - Roberta Polverosi AU - Davide Biondini AU - Alessia Fraccaro AU - Piera Peditto AU - Manuel G. Cosio AU - Marina Saetta AU - Elisabetta Balestro Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA792.abstract N2 - Background: The clinical course of IPF is heterogeneous however it is recognized that patients can have a slow (S) or rapid (R) progression of the disease and that R is related to worse prognosis.Aims: By using a HRCT alveolar score (AS) as an index of alveolar inflammation and an interstitial score (IS) as an index of fibrosis we wanted to investigate: 1) If AS and IS could differentiate S from R at a time close to diagnosis; 2) The behavior of the AS and IS over time; 3)The relation of FVC decline to the progression of AS and IS.Methods: 28 IPF patients (17S, 11R) followed longitudinally with FVC had a HRCT close to diagnosis (HRCT1). 13 of these patients (7S and 6R) had a second HRCT2 after 30±25 months of follow up. Ground glass (AS) and fibrosis (IS) % extension (0-100) were scored in each lobe. HRCT1 and HRCT2 scores were computed, the rate of progression calculated and compared to the FVC change between the interval from HRCT1 to HRCT2.Results: In the 28 patients examined at diagnosis, HRCT1 AS in R (23.4±22%) was higher than in S (8.4±14.1%, p< 0.03) while IS was similar (42.2±21% in R vs 41.1±24% in S). In the 13 patients in whom HRCT2 was available, AS significantly increased in S (5.7±8 to 15.4±17%, p<0.05) and R (22±29 to 30±30%, p<0.05) while IS did not increase significantly. The rate of decline of FVC between HRCT1 and HRCT2 correlated strongly with the combined AS and IS change/month (r=0.80, p<0.005).Conclusion: At diagnosis HRCT AS differentiates R from S progressors. The combination of progressive inflammation (AS) and fibrosis (IS) by HRCT seems to drive the functional decay in IPF. ER -