Possibilities of computed tomography densitovolumetry in assessing the dynamics of structural and functional changes in the lungs of patients with pulmonary sarcoidosis

Abstract

Aim. To evaluate the dynamics of structural and functional changes in the lungs of pulmonary sarcoidosis patients using computed tomography (CT) densitovolumetry with the purpose of predicting the course of the disease.Materials and methods. Patients with respiratory sarcoidosis were examined at the starting point (n = 101) and at the end of one-year follow-up (n = 79). The function of external respiration was assessed according to the spirometry of forced expiration, body plethysmography, and the study of diffusion capacity and lung volumes. All the examined patients underwent a two-stage CT of the lungs in the inspiratory and expiratory phases using the CT densitovolumetry method. The dynamics of quantitative indicators of structural and functional changes in the lungs was assessed.Results. At the end of the follow-up period, the patients showed a negative, stable, and positive radiological dynamics. Changes were observed not only in the qualitative signs of radiological patterns specific to sarcoidosis, but also in the quantitative data obtained by CT densitovolumetry. The CT densitovolumetry indicator (the inspiratory index of both lungs) and spirometry indicators (the peak expiratory flow rate and the FEV1/FVC ratio) with respect to the normal values can be used as independent predictors for pulmonary sarcoidosis progression during a year with high accuracy. Conclusion. CT densitovolumetry indicators can be used to quantify the structural and functional changes in the lungs and to predict the progressive course of pulmonary sarcoidosis with the purpose of modifying the therapy.