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Open Access 06-05-2024 | Computed Tomography | Original Article

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

Authors: Pin-Yi Chiang, Yu-Sen Huang, Yu-Cheng Huang, Ming-Yann Lee, Victor Jing-Wei Kang, Chin-Chung Shu, Yeun-Chung Chang

Published in: Japanese Journal of Radiology

Abstract

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 < 0.05) were significant predictors of treatment failure.

Conclusions

A high pre-treatment cavitation extension score and an increase in the consolidation extension score during treatment on CT could be alarm signs of treatment failure requiring tailor the treatment of MABC-LD carefully.

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Title: CT findings as predictive factors for treatment failure in Mycobacterium abscessus complex lung disease: a retrospective cohort study
Authors: Pin-Yi Chiang
Yu-Sen Huang
Yu-Cheng Huang
Ming-Yann Lee
Victor Jing-Wei Kang
Chin-Chung Shu
Yeun-Chung Chang
Publication date: 06-05-2024
Publisher: Springer Nature Singapore
Keywords: Computed Tomography
Computed Tomography
Bronchiectasis
Bronchiolitis
Non-Tuberculous Mycobacteria
Published in: Japanese Journal of Radiology
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-024-01570-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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