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Thin-Section CT in Patients with Cystic Fibrosis: Correlation with Peak Exercise Capacity and Body Mass Index¹

¹ From the Department of Radiology (J.D.D., S.J.S., J.B.M.) and The National Referral Centre for Adult Cystic Fibrosis (S.C.B., R.B.M.B., C.G.G.), St Vincent's University Hospital, Dublin, Ireland. Received March 26, 2005; revision requested May 19; revision received August 17; final version accepted September 14. Supported by the Health Research Board of Ireland, the Cystic Fibrosis Research Trust Fund of Ireland, and the Department of Radiology, St Vincent's University Hospital. Address correspondence to J.D.D., Department of Radiology, Vancouver General Hospital, 855 W 12th Ave, Vancouver, BC, Canada V6K 1R4 (e-mail: jddodd{at}partners.org).

Purpose: To evaluate whether thin-section chest computed tomographic (CT) findings correlate with exercise capacity, body mass index (BMI), dyspnea, and leg discomfort in patients with cystic fibrosis (CF).

Materials and Methods: Institutional ethics committee approval was obtained, and patients provided written informed consent. Twenty-two patients (13 male and nine female patients; mean age, 22 years ± 5.9; age range, 17–41 years) with stable CF underwent thin-section CT and exercise testing on a cycle ergometer. Three radiologists blinded to the clinical severity of disease and the spirometric findings of all patients independently and randomly scored all scans with a modified Bhalla scoring system. The primary measurement of the outcome of exercise testing was percentage of predicted peak O₂ uptake. Univariate (Spearman rank correlation) and multivariate analyses were used to compare thin-section CT, clinical (age, sex, spirometric data, and BMI), and exercise measurements.

Results: The correlation between total thin-section CT score and percentage of predicted peak O₂ uptake was stronger than the correlation between the percentage of predicted peak O₂ uptake and any clinical measurement (R = –0.60, P < .01). The thin-section CT structural abnormalities that had the strongest correlation with percentage of predicted peak O₂ uptake were severity of bronchiectasis and presence of sacculations or abscesses (R = –0.70 and –0.71, respectively; P < .01). Multivariate analysis showed total thin-section CT score to be the only significant predictor of exercise capacity, accounting for 42% of the variance in percentage of predicted peak O₂ uptake.

Conclusion: In patients with CF, the correlation between thin-section CT score and exercise limitation is stronger than that between spirometry results or BMI and exercise limitation.

© RSNA, 2006

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