The relationship between radiological features of DIPNECH, and clinical symptoms and physiology

DIPNECH is poorly understood. Not all patients are symptomatic and the driver for respiratory symptoms and lung function is unknown. Radiologically, pulmonary nodules are common, but the significance of this finding or the burden of nodules also remains unknown. We compared data from 256 patients with DIPNECH across 18 international centres, specifically looking for associations between radiological findings, and symptomatology and PFTs. The number of nodules on chest CT was divided into categories where available (n=140/252); 0- 10, 11- 20 and >20 nodules with 72.1% (n=101/140), 10.7% (n=15/140) and 17.1% (n=24/140) in each group respectively. While the number of nodules detected on chest CT had no significant correlation with DLCO% predicted (p=0.9698, R2 = -0.013), it was weakly but significantly correlated with FEV1 %predicted (p=0.0006, R2 = 0.087). Approximately 8.7% of the FEV1% predicted variance can be explained by the number of nodules detected radiologically. Although there was no significant association between the presence of respiratory symptoms and airway dilatation seen on chest CT (χ^2=1.976, p= 0.160), significant associations existed between the presence of respiratory symptoms (cough, dyspnea or wheezing) and both mosaic attenuation on chest CT (χ^2=8.672, p=0.003) and an obstructive spirometry pattern (χ^2=3.943, p=0.047). However, when individual symptoms (cough, dyspnea, and wheezing) were considered, they were not associated with chest CT findings (airway dilatation [χ^2=1.403, p= 0.496] or mosaic attenuation [χ^2=0.693, p= 0.496]), nor with an obstructive PFT pattern (χ^2=0.356, p= 0.837). More attention is warranted when reviewing DIPNECH radiological features.

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Published
2025-09-27
DOI
https://doi.org/10.1183/13993003.congress-2025.pa1562
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
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article
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article

The relationship between radiological features of DIPNECH, and clinical symptoms and physiology

Camille Taillé, Bilal F. Samhouri, Rachel Crowley, Ludovic Fournel et al.
Chronic Obstructive Pulmonary Disease (COPD) Research
article

The relationship between radiological features of DIPNECH, and clinical symptoms and physiology

Camille Taillé, Bilal F. Samhouri, Rachel Crowley, Ludovic Fournel, Marcel Veltkamp, Rémi Diesler, Michael P. Keane, Lykourgos Kolilekas, Marissa O’Callaghan, A. Lazaratou, Cormac McCarthy, Zoe Daniil, Francesco Bonella, Cottin Vincent, Paolo Spagnolo, Filippo Lococo, Wieneke A. Buikhuisen, Alessandro Franciosi, Aurélie Fabre, David Murphy, Nishant Gupta, Sarah H. Forde, Spiridon Papiris, Ilias Dimeas, Fernanda Hernandez, Demosthenes Bouros, Jay Hoon Ryu, Jonathan Strosberg, Adam J. Byrne, Effrosyni D. Manali, Sergio Harari, M. Penugonda, S Quinn, Francis X. McCormack, Hussein Almeamar, Dónal O’Shea, Laurie Carr, H. O'Brien, O'Toole Dermot
article en

Abstract

DIPNECH is poorly understood. Not all patients are symptomatic and the driver for respiratory symptoms and lung function is unknown. Radiologically, pulmonary nodules are common, but the significance of this finding or the burden of nodules also remains unknown. We compared data from 256 patients with DIPNECH across 18 international centres, specifically looking for associations between radiological findings, and symptomatology and PFTs. The number of nodules on chest CT was divided into categories where available (n=140/252); 0- 10, 11- 20 and >20 nodules with 72.1% (n=101/140), 10.7% (n=15/140) and 17.1% (n=24/140) in each group respectively. While the number of nodules detected on chest CT had no significant correlation with DLCO% predicted (p=0.9698, R2 = -0.013), it was weakly but significantly correlated with FEV1 %predicted (p=0.0006, R2 = 0.087). Approximately 8.7% of the FEV1% predicted variance can be explained by the number of nodules detected radiologically. Although there was no significant association between the presence of respiratory symptoms and airway dilatation seen on chest CT (χ^2=1.976, p= 0.160), significant associations existed between the presence of respiratory symptoms (cough, dyspnea or wheezing) and both mosaic attenuation on chest CT (χ^2=8.672, p=0.003) and an obstructive spirometry pattern (χ^2=3.943, p=0.047). However, when individual symptoms (cough, dyspnea, and wheezing) were considered, they were not associated with chest CT findings (airway dilatation [χ^2=1.403, p= 0.496] or mosaic attenuation [χ^2=0.693, p= 0.496]), nor with an obstructive PFT pattern (χ^2=0.356, p= 0.837). More attention is warranted when reviewing DIPNECH radiological features.

Université Claude Bernard Lyon 1 (FR), University College Dublin (IE), Università Cattolica del Sacro Cuore (IT), Délégation Paris 5 (FR), Mayo Clinic (US), University of Padua (IT), National and Kapodistrian University of Athens (GR), Université Paris Cité (FR), Moffitt Cancer Center (US), National Jewish Health (US), Ruhrlandklinik (DE), Assistance Publique – Hôpitaux de Paris (FR), St. Antonius Ziekenhuis (NL), University Hospital of Larissa (GR), Hospital Clínic de Barcelona (ES), St. Vincent's University Hospital (IE), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NL), Mayo Clinic in Arizona (US), Hôpital Louis Pradel (FR), Institut Cochin (FR), Mayo Clinic in Florida (US), Ospedale San Giuseppe (IT), Sotiria General Hospital (GR), University of Cincinnati (US), University of Colorado Denver (US)
Openalex Percentile: Top 48%
Chronic Obstructive Pulmonary Disease (COPD) Research
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