The usefulness of change in CT score for evaluating the activity of Mycobacterium abscessus (Mab) pulmonary disease (Mab-PD)

PLoS One. 2023 Feb 8;18(2):e0281103. doi: 10.1371/journal.pone.0281103. eCollection 2023.

Abstract

Objectives: Semi-quantitative CT score is generally used for evaluating the disease status of Mycobacterium abscessus (Mab) Pulmonary disease (Mab-PD). However, its accuracy and clinical usefulness are limited, since the CT score is largely affected by coexisting lung disease. Hence, we hypothesized that numerical change in CT score during the observation period may be useful for evaluating disease activity of Mab-PD.

Methods: Patients diagnosed with Mab-PD based on the official ATS/ERS/ESCMID/IDSA statement at Jikei University Hospital and Jikei Daisan Hospital between 2015 January 1 and 2021 July 31 were included (n = 32). We reviewed the medical records, and bacteriological and laboratory data of the patients. Chest CT was performed at diagnosis in all 32 cases. In 18 cases, chest CT images within 4 years before diagnosis were available. The numerical change in CT score between two time points was calculated and the association of the CT scores with sputum Gaffky score and serum CRP was examined.

Results: CT score at diagnosis was not correlated with sputum Gaffky score nor serum CRP, while the difference of absolute value and change rate in CT score between at diagnosis and immediate past CT were well correlated with both sputum Gaffky score and serum CRP.

Conclusions: Chronological change in CT score may more precisely reflect the disease activity of airway mycobacterial burden and systemic inflammation in Mab-PD at the timing of diagnosis.

Publication types

  • Review

MeSH terms

  • Humans
  • Lung / diagnostic imaging
  • Lung / microbiology
  • Lung Diseases* / diagnostic imaging
  • Mycobacterium Infections, Nontuberculous* / diagnostic imaging
  • Mycobacterium Infections, Nontuberculous* / microbiology
  • Mycobacterium abscessus*
  • Tomography, X-Ray Computed / methods

Grants and funding

he author(s) received no specific funding for this work.