Related Experiment Video
Updated: Feb 6, 2026
Refined Murine Model of Idiopathic Pulmonary Fibrosis
Published on: June 17, 2025
Quantitative chest computerized tomography and FEV1 equally identify pulmonary exacerbation risk in children with
Don B Sanders1, Zhanhai Li2, Katelyn Parker-McGill3
1Department of Pediatrics, Riley Hospital for Children, School of Medicine, Indiana University, Indianapolis, Indiana.
Insights
Identifying children with cystic fibrosis (CF) at risk for pulmonary exacerbations is crucial. New CT score cut-offs help differentiate mild lung disease, guiding risk assessment for frequent exacerbations.
Area of Science:
- Pulmonary Medicine
- Radiology
- Pediatrics
Background:
- Chest computerized tomography (CT) scores correlate with future pulmonary exacerbations in cystic fibrosis (CF).
- Identifying specific CT score cut-offs for children with mild CF lung disease and varying exacerbation risks remains challenging.
Purpose of the Study:
- To establish cut-off values for chest CT scores to identify children with CF and mild lung disease at different risks for future pulmonary exacerbations.
- To compare the predictive performance of CT scores with lung function measurements for exacerbation risk.
Main Methods:
- Chest CT scans were analyzed using the Brody score in two cohorts: the Pulmozyme Early Intervention Trial (PEIT) and the Wisconsin Randomized Clinical Trial of CF Newborn Screening (WI RCT).
- Receiver operating characteristic (ROC) curves were used to evaluate Brody scores and forced expiratory volume in 1-second (FEV1)% predicted against the frequency of pulmonary exacerbations over 10 years.
Main Results:
- The optimal Brody score cut-offs for identifying children at risk for ≥0.3 annual pulmonary exacerbations were 3.6 in the PEIT and 2.1 in the WI RCT.
- No significant differences were found between the ROC curves for Brody CT scores and FEV1% predicted in either study, indicating similar predictive abilities.
Conclusions:
- CT score cut-offs can identify children with CF and mild lung disease at different risks for frequent pulmonary exacerbations.
- Brody scores and FEV1% predicted demonstrate comparable efficacy in risk stratification, suggesting FEV1% predicted alone may suffice for predicting future exacerbation frequency.
Background:
Chest computerized tomography (CT) scores are associated with the frequency of future pulmonary exacerbations in people with cystic fibrosis (CF). However, cut-off values to identify children with mild lung disease with different risks for frequent future pulmonary exacerbations have not been identified.
Methods:
Chest CT scans were assessed using the Brody score for participants of the Pulmozyme Early Intervention Trial (PEIT) and Wisconsin Randomized Clinical Trial of CF Newborn Screening (WI RCT). We determined the area under the receiver operating characteristic (ROC) curve for Brody scores and forced expiratory volume in 1 s (FEV1 ) to compare with the frequency of pulmonary exacerbations up to 10 years later.
Results:
There were 60 participants in the PEIT with mean (SD) age 10.6 (1.7) years at the time of the CT and 81 participants in the WI RCT with mean age 11.5 (3.0) years. The Brody score cut-off that best identified children at-risk for ≥0.3 annual pulmonary exacerbations was 3.6 in the PEIT and 2.1 in the WI RCT. There were no statistical differences between ROC curves for the Brody CT score and FEV1 % predicted in either study (P ≥ 0.4).
Conclusions:
CT score cut-off values that identify children with CF with mild lung disease at different risks for frequent pulmonary exacerbations over an extended follow up period are similar in separate cohorts. Brody scores and FEV1 % predicted have similar abilities to identify these children, suggesting that FEV1 % predicted alone may be adequate for predicting future frequency of pulmonary exacerbations.
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