• Tae Iwasawa, Takashi Ogura, Fumikazu Sakai, Tetsu Kanauchi, Takanobu Komagata, Tomohisa Baba, Toshiyuki Gotoh, Satoshi Morita, Takuya Yazawa, and Tomio Inoue.
• Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. Electronic address: tae_i_md@wb3.so-net.ne.jp.
• Eur J Radiol. 2014 Jan 1;83(1):32-8.

PurposePirfenidone is a new, anti-fibrotic drug used for the treatment of idiopathic pulmonary fibrosis (IPF). The aim of this study was to evaluate the utility of computed tomography (CT) in the imaging assessment of the response to pirfenidone therapy.Materials And MethodsSubjects were 78 patients with IPF who underwent CT on two occasions with one-year interval (38 consecutive patients treated with pirfenidone and 40 age-matched control). Changes in the fibrous lesion on sequential CTs were assessed as visual score by two radiologists. We measured the volume and change per year of fibrous pattern (F-pattern) quantitatively using a computer-aided system on sequential CTs.ResultsThe baseline vital capacity (%pred VC) was 74.0 ± 14.0% in the pirfenidone group and 74.6 ± 16.6% in controls (p=NS). Deterioration of respiratory status was defined as 10% or greater decline in %pred VC value after 12-month treatment. A significantly larger proportion of pirfenidone-treated patients showed stable respiratory status (21 of 38, 65.6%) than the control (15 of 40, 37.5%). The change in fibrous lesion was significantly smaller in the pirfenidone group than the control in both of visual score (p=0.006) and computer analysis (p<0.001). The decline in VC correlated significantly with the increase in fibrotic lesion (p<0.001).ConclusionCT can be used to assess pirfenidone-induced slowing of progression of pulmonary fibrosis.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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