CT findings as predictive factors for treatment failure in Mycobacterium abscessus complex lung disease: a retrospective cohort study

Purpose Mycobacterium abscessus complex (MABC) commonly causes lung disease (LD) and has a high treatment failure rate of around 50%. In this study, our objective is to investigate specific CT patterns for predicting treatment prognosis and monitoring treatment response, thus providing valuable insi...

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Bibliographic Details
Published in:Japanese journal of radiology 2024-08, Vol.42 (8), p.852-861
Main Authors: Chiang, Pin-Yi, Huang, Yu-Sen, Huang, Yu-Cheng, Lee, Ming-Yann, Kang, Victor Jing-Wei, Shu, Chin-Chung, Chang, Yeun-Chung
Format: Article
Language:English
Subjects:
Bronchiectasis
Bronchopneumonia
Cavitation
Consolidation
Correlation coefficient
Correlation coefficients
Diameters
Failure
Health services
Imaging
Lung diseases
Medicine
Medicine & Public Health
Mycobacterium abscessus
Nodules
Nuclear Medicine
Original
Original Article
Radiology
Radiotherapy
Regression analysis
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Summary:Purpose Mycobacterium abscessus complex (MABC) commonly causes lung disease (LD) and has a high treatment failure rate of around 50%. In this study, our objective is to investigate specific CT patterns for predicting treatment prognosis and monitoring treatment response, thus providing valuable insights for clinical physicians in the management of MABC-LD treatment. Methods We retrospectively assessed 34 patients with MABC-LD treated between January 2015 and December 2020. CT scores for bronchiectasis, cellular bronchiolitis, consolidation, cavities, and nodules were measured at initiation and after treatment. The ability of the CT scores to predict treatment outcomes was analyzed in logistic regression analyses. Results The CT scoring system had excellent inter-reader agreement (all intraclass correlation coefficients, > 0.82). The treatment failure (TF) group (17/34; 50%) had higher cavitation diameter ( p  = 0.049) and extension ( p  = 0.041) at initial CT and higher cavitation diameter ( p  = 0.049) and extension ( p  =0 .045), consolidation ( p  = 0.022), and total ( p  = 0.013) scores at follow-up CT than the treatment success (TS) group. The changes of total score and consolidation score ( p  = 0.049 and 0.024, respectively) increased in the TF group more than the TS group between the initial and follow-up CT. Multivariable logistic regression analysis showed initial cavitation extension, follow-up consolidation extension, and change in consolidation extension (adjusted odds ratio: 2.512, 2.495, and 9.094, respectively, per 1-point increase; all p  
ISSN:1867-1071
1867-108X
1867-108X
DOI:10.1007/s11604-024-01570-y