The diagnostic utility of chest computed tomography scoring for the assessment of amiodarone-induced pulmonary toxicity
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Background/Aims: Amiodarone is one of the most widely used antiarrhythmicagents; however, amiodarone-induced pulmonary toxicity (APT) can be irreversibleand sometimes fatal. The aim of this study was to evaluate the feasibility ofchest computed tomography (CT) as a diagnostic tool for APT and to assess theutility of the CT APT score as an index for predicting the severity of APT. Methods: Patients underwent amiodarone treatment for various reasons, mostoften atrial fibrillation, for more than 2 years, and those that received a cumulativedose > 100 g were enrolled. A total of 34 patients who underwent chest CT betweenDecember 2011 and June 2012 were enrolled, whether or not they had clinicalsymptoms. The APT CT score was defined as the number of involved regionsin the lung, which was divided into 18 regions (right and left, upper, middle, andlower, and central, middle, and peripheral). The CT findings were evaluated accordingto the total dose and duration of amiodarone treatment and the results ofa pulmonary function test. Clinical symptoms and outcomes were also evaluatedaccording to APT CT scores. Results: Seven patients had positive APT CT scores (interstitial fibrosis in five, organizingpneumonia in one, and mixed interstitial fibrosis and organizing pneumoniain one), and these patients exhibited significantly lower diffusion capacityfor carbon monoxide in the lungs compared with patients without an increasedAPT CT score (70.2% ± 6.9% vs. 89.7% ± 19.4%; p = 0.011). Three of the seven patientsexperienced overt APT that required hospital admission. Conclusions: Chest CT is a useful diagnostic tool for APT, and the APT CT scoremight be a useful index for assessing the severity of APT.
Abstract
Background/Aims: Amiodarone is one of the most widely used antiarrhythmicagents; however, amiodarone-induced pulmonary toxicity (APT) can be irreversibleand sometimes fatal. The aim of this study was to evaluate the feasibility ofchest computed tomography (CT) as a diagnostic tool for APT and to assess theutility of the CT APT score as an index for predicting the severity of APT. Methods: Patients underwent amiodarone treatment for various reasons, mostoften atrial fibrillation, for more than 2 years, and those that received a cumulativedose > 100 g were enrolled. A total of 34 patients who underwent chest CT betweenDecember 2011 and June 2012 were enrolled, whether or not they had clinicalsymptoms. The APT CT score was defined as the number of involved regionsin the lung, which was divided into 18 regions (right and left, upper, middle, andlower, and central, middle, and peripheral). The CT findings were evaluated accordingto the total dose and duration of amiodarone treatment and the results ofa pulmonary function test. Clinical symptoms and outcomes were also evaluatedaccording to APT CT scores. Results: Seven patients had positive APT CT scores (interstitial fibrosis in five, organizingpneumonia in one, and mixed interstitial fibrosis and organizing pneumoniain one), and these patients exhibited significantly lower diffusion capacityfor carbon monoxide in the lungs compared with patients without an increasedAPT CT score (70.2% ± 6.9% vs. 89.7% ± 19.4%; p = 0.011). Three of the seven patientsexperienced overt APT that required hospital admission. Conclusions: Chest CT is a useful diagnostic tool for APT, and the APT CT scoremight be a useful index for assessing the severity of APT.
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