Demographic and physiologic differences between fibrotic and non-fibrotic CT subtypes of sarcoidosis.
cross_sectional · Level IV
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- Record sourced from PubMed, PMID 41794119.
- Also identified by DOI 10.1016/j.chest.2026.02.006.
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Abstract
One approach to categorizing patients using chest computed tomography (CT) imaging manifestations of pulmonary sarcoidosis is into three classifications: fibrotic, non-fibrotic, or no parenchymal abnormality. We aimed to evaluate the relationships between these imaging subtypes and demographic and physiologic variables in a large group of sarcoidosis patients with chest CT. Do individuals with fibrotic sarcoidosis have more severe physiologic impairment than those with non-fibrotic sarcoidosis and those with no parenchymal abnormality, and are there CT subtypes of fibrosis that are associated with different physiologic subtypes? The study included individuals with sarcoidosis from two large medical centers seen between 2008 and 2018 and from the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) consortium and received a high-resolution CT and spirometry and lung diffusing capacity within 180 days (N=932). Pulmonary function phenotypes were characterized based on spirometry and lung diffusing capacity. CT patterns were systematically classified as fibrotic, non-fibrotic or no parenchymal abnormality based on standardized visual assessment. Multinomial logistic regression analyzed the relationship between pulmonary function and CT categories. Among the 942 patients, 353 (38%) had fibrosis, 380 (41%) had non-fibrotic abnormalities, and 199 (21%) had no parenchymal abnormality. Individuals with fibrotic abnormalities were older, had longer time since diagnosis, more impaired spirometry and diffusing capacity, and larger pulmonary artery diameter than those without (p<0.001 for all). Among subjects with fibrosis, those with a conglomerate mass were 9 times more likely to have a mixed pattern of spirometric impairment (p<0.01). Individuals with fibrotic pulmonary sarcoidosis demonstrate distinct demographic and spirometric differences. Subtypes of fibrosis demonstrate different lung function abnormalities.