Dados do Trabalho

Título

Unlocking the Clinical Potential of Paired Inspiratory and Expiratory CT scans in the Differential Diagnosis of Cystic Lung Diseases: A Systematic Review

Descrição sucinta do(s) objetivo(s)

Cystic lung diseases (CLDs) encompass a heterogeneous group of pulmonary conditions, and the traditional inspiratory CT scans often pose diagnostic challenges. To overcome the overlapping radiological features during inspiratory scans and narrow the differential diagnosis of CLDs, recent studies have suggested the use of paired inspiratory and expiratory CT scans to assess the degree of communication between cysts and the airway by measuring changes in cyst size during the respiratory phases.
The objective of this study was to conduct a systematic review on the application of paired inspiratory and expiratory CT scans in evaluating CLDs

Descrição da(s) doença(s), método(s) e/ou técnica(s)

A systematic search was performed in PubMed, Scopus, Embase, BVS, and Cochrane through August 2023. Full-text articles involving expiratory CT in adults (≥18 years) previously diagnosed with cystic lung disease confirmed through histopathology or radiological features were included. The outcome analyzed by the studies should be the reduction in cyst size. The selection process for the included studies is depicted in Figure 1.

Discussão

Out of the 96 records identified in the systematic search after duplicate removal, three studies met the criteria for inclusion and were analyzed, comprising a total of 149 participants and 513 cystic lesions. Several CLDs were addressed in the articles, with honeycombing being the only common diagnosis evaluated by all of them. Pulmonary Langerhans Cell Histiocytosis, Lymphangioleiomyomatosis, honeycombing and bronchiectasis showed the most significant respiratory changes, while paraseptal emphysema and bullae had the least changes. Additional information regarding patient characteristics and methodological details is described in Tables 1 and 2, respectively. Table 3 provides a more comprehensive overview of the diagnosis covered in each article as well as the findings.

Conclusões

The studies analyzed consistently showed a reduction in cyst size during expiration, with the extent of variation differed among the pathologies examined. This reduction in size may be attributed to airway-cyst communication, with higher degrees of variation reflecting a greater connection. The findings suggest that expiratory CT can be a valuable tool in the radiological differential diagnosis of cystic lung diseases, potentially reducing the reliance on invasive procedures such as pulmonary biopsies.

Palavras Chave

cystic lung disease; computed tomography; expiratory.

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