Idiopathic Nonspecific Interstitial Pneumonia: Changes in High-Resolution Computed Tomography on Long-Term Follow-Up

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ObjectiveThis study aimed to assess the change in findings of nonspecific interstitial pneumonia (NSIP) from high-resolution computed tomography (HRCT) on long-term follow-up (median, 38 months).Materials and MethodsA retrospective review of changes in HRCT in 68 patients with NSIP (fibrotic progression, 61) with follow-up HRCT of at least 1-year interval was conducted.ResultsFollow-up HRCT findings showed a decreased extent of ground-glass opacity and consolidation, with increased honeycombing, traction bronchiectasis, and architectural distortion (all P < 0.05). Radiological improvement was seen in 36%, stability was seen in 23%, and fibrotic progression was seen with recurrence in 13% and without recurrence in 28%. In 3 patients (4.9%), HRCT converted to a definite usual interstitial pneumonia pattern. Honeycombing and reticulation were independent predictors for mortality in fibrotic NSIP (P < 0.01).ConclusionsAlthough most of the follow-up HRCT scans showed improvement in the extent of ground-glass opacity and consolidation, approximately one third showed fibrotic progression or recurrence, with transition from NSIP to definite usual interstitial pneumonia pattern.

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