Children's interstitial lung disease: Multidetector computed tomography patterns and correlations between imaging and...

Area of Science:

• Pediatric Pulmonology
• Radiology
• Rare Diseases

Background:

• Childhood interstitial lung disease (chILD) encompasses diverse rare lung conditions unique to pediatric populations.
• Diagnosis relies on clinical findings, multidetector computed tomography (MDCT), genetic analysis, lung function tests, and lung biopsy.
• The diagnostic utility of MDCT pattern recognition in chILD remains underexplored.

Purpose of the Study:

• To investigate the prevalence of specific MDCT patterns in children with histologically confirmed interstitial lung disease.
• To assess the predictive value of identified MDCT patterns for the final chILD diagnosis.

Main Methods:

• Retrospective analysis of biopsy, MDCT, and clinical data from 90 pediatric patients (2004-2020).
• MDCT images were reviewed by blinded experts.
• Histological findings were classified according to established chILD categories.

Main Results:

• Sixty-three percent of the 90 included patients were male, with a median biopsy age of 1.3 years.
• Six distinct MDCT patterns were identified: neuroendocrine cell hyperplasia of infancy, organizing pneumonia, non-specific interstitial pneumonia, bronchiolitis obliterans, pulmonary alveolar proteinosis, and bronchopulmonary dysplasia.
• A recognizable MDCT pattern was present in 43% of patients; of these, 87% had a pattern predictive of the final diagnosis. In 57% of cases, no specific pattern was recognized.

Conclusions:

• Specific MDCT patterns are identified in less than half of childhood interstitial lung disease cases.
• When a distinct MDCT pattern is recognized in chILD, it demonstrates significant predictive value for the final diagnosis.