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CT Imaging Assessment of Response to Treatment in Allergic Bronchopulmonary Aspergillosis in Adults With Bronchial Asthma

dc.rights.licenseopenen_US
hal.structure.identifierAP-HP - Hôpital Bichat - Claude Bernard [Paris]
hal.structure.identifierUniversité Paris Cité [UPCité]
dc.contributor.authorGODET, Cendrine
hal.structure.identifierHôpital Foch [Suresnes]
dc.contributor.authorBRUN, Anne-Laure
hal.structure.identifierCentre Hospitalier Régional Universitaire de Brest [CHRU Brest]
hal.structure.identifierGroupe d'Etude de la Thrombose de Bretagne Occidentale [GETBO]
hal.structure.identifierCIC Brest
dc.contributor.authorCOUTURAUD, Francis
hal.structure.identifierUniversité de Bordeaux [UB]
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorLAURENT, François
hal.structure.identifierCIC Poitiers – Centre d'investigation clinique de Poitiers [CIC 1402]
hal.structure.identifierCentre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
dc.contributor.authorFRAT, Jean-Pierre
hal.structure.identifierUniversité de Tours [UT]
hal.structure.identifierCentre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 [CEPR]
hal.structure.identifierCentre Hospitalier Régional Universitaire de Tours [CHRU Tours]
dc.contributor.authorMARCHAND-ADAM, Sylvain
hal.structure.identifierCentre Hospitalier Universitaire d'Angers [CHU Angers]
dc.contributor.authorGAGNADOUX, Frédéric
hal.structure.identifierHôpital Haut-Lévêque - CHU de Bordeaux [Centre médico chirurgical Magellan]
dc.contributor.authorBLANCHARD, Elodie
hal.structure.identifierAP-HP - Hôpital Bichat - Claude Bernard [Paris]
hal.structure.identifierPhysiopathologie et Epidémiologie des Maladies Respiratoires [PHERE (UMR_S_1152 / U1152)]
dc.contributor.authorTAILLÉ, Camille
hal.structure.identifierCentre Hospitalier René Dubos [Pontoise]
dc.contributor.authorPHILIPPE, Bruno
hal.structure.identifierLes Hôpitaux Universitaires de Strasbourg [HUS]
dc.contributor.authorHIRSCHI, Sandrine
hal.structure.identifierAgents infectieux, résistance et chimiothérapie - UR UPJV 4294 [AGIR ]
hal.structure.identifierCHU Amiens-Picardie
dc.contributor.authorANDRÉJAK, Claire
hal.structure.identifierPhysiologie & médecine expérimentale du Cœur et des Muscles [U 1046] [PhyMedExp]
hal.structure.identifierCentre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
dc.contributor.authorBOURDIN, Arnaud
hal.structure.identifierService de Pneumologie et Immuno-Allergologie [CHU LIlle]
hal.structure.identifierCentre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
dc.contributor.authorCHENIVESSE, Cécile
hal.structure.identifierCHU Rouen
dc.contributor.authorDOMINIQUE, Stéphane
hal.structure.identifierCentre Hospitalier Intercommunal de Créteil [CHIC]
dc.contributor.authorMANGIAPAN, Gilles
hal.structure.identifierService Pneumologie-Allergologie [CHU Toulouse]
hal.structure.identifierCentre de Ressources et de Compétences en Mucoviscidose [CHU Toulouse] [CRCM Toulouse]
dc.contributor.authorMURRIS-ESPIN, Marlène
hal.structure.identifierHôpital Côte de Nacre [CHU Caen]
dc.contributor.authorRIVIÈRE, Frédéric
hal.structure.identifierUniversité Paris-Saclay
hal.structure.identifierService de pneumologie et de soins intensifs respiratoires [AP-HP, Hôpital Bicêtre] [Centre de Référence de l'hypertension pulmonaire sévère] [USI Pneumologie]
hal.structure.identifierPôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
hal.structure.identifierHôpital Marie-Lannelongue
dc.contributor.authorGARCIA, Gilles
hal.structure.identifierCentre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
hal.structure.identifierCentre d’Investigation Clinique de Nantes [CIC Nantes]
hal.structure.identifierITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291 [ITX-lab]
dc.contributor.authorBLANC, François-Xavier
hal.structure.identifierCentre Hospitalier Le Mans (CH Le Mans)
dc.contributor.authorGOUPIL, François
hal.structure.identifierHôpitaux universitaires de Genève = University Hospitals of Geneva [HUG]
dc.contributor.authorBERGERON, Anne
hal.structure.identifierCentre Hospitalier Régional Universitaire de Tours [CHRU Tours]
dc.contributor.authorFLAMENT, Thomas
hal.structure.identifierCentre Hospitalier Universitaire d'Angers [CHU Angers]
dc.contributor.authorPRIOU, Pascaline
hal.structure.identifierAP-HP - Hôpital Bichat - Claude Bernard [Paris]
hal.structure.identifierUniversité Paris Cité [UPCité]
dc.contributor.authorMAL, Hervé
hal.structure.identifierCIC Poitiers – Centre d'investigation clinique de Poitiers [CIC 1402]
dc.contributor.authorDE KEIZER, Joe
hal.structure.identifierCIC Poitiers – Centre d'investigation clinique de Poitiers [CIC 1402]
dc.contributor.authorRAGOT, Stéphanie
hal.structure.identifierCHU Tenon [AP-HP]
hal.structure.identifierSorbonne Université [SU]
dc.contributor.authorCADRANEL, Jacques
dc.date.accessioned2025-06-18T10:48:05Z
dc.date.available2025-06-18T10:48:05Z
dc.date.issued2024-02-01
dc.identifier.issn0012-3692en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/206951
dc.description.abstractEnBackground: One of the major challenges in managing allergic bronchopulmonary aspergillosis (ABPA) remains consistent and reproducible assessment of response to treatment.Research questionWhat are the most relevant changes in computed tomography (CT-scan) parameters over time for assessing response to treatment?Study Design and Methods: In this ancillary study of a randomized clinical trial (NEBULAMB), asthmatic patients with available CT-scan and without exacerbation during a 4-month ABPA exacerbation treatment period (corticosteroids and itraconazole) were included. Changed CT-scan parameters were assessed by systematic analyses of CT-scan findings at initiation (M0) and end of treatment (M4). CT-scans were assessed by two radiologists blinded to the clinical data. Radiological parameters were determined by selecting those showing significant changes over time. Improvement of at least one, without worsening of the others, defined the radiological response. Agreement between radiological changes, clinical and immunologic responses was likewise investigated.Results: Among the 139 originally randomized patients, 132 were included. We identified 5 CT-scan parameters showing significant changes at M4: mucoid impaction extent, mucoid impaction density, centrilobular micronodules, consolidation/ground-glass opacities and bronchial wall thickening (P<0.05). These changes were only weakly associated with one another, except for mucoid impaction extent and density. No agreement was observed between clinical or immunologic and radiological responses, assessed as an overall response, or considering each of the parameters (Cohen’s κ, -0.01 to 0.24).Interpretation: Changes in extent and density of mucoid impactions, centrilobular micronodules, consolidation/ground-glass opacities and thickening of the bronchial walls were found to be the most relevant CT-scan parameters to assess radiological response to treatment. A clinical, immunologic and radiological multidimensional approach should be adopted to assess outcomes, probably with a composite definition of response to treatment.
dc.language.isoENen_US
dc.subject.enABPA
dc.subject.enCT scan
dc.subject.enallergic bronchopulmonary aspergillosis
dc.subject.enradiologic response
dc.subject.entreatment outcomes
dc.subject.meshAdrenal Cortex Hormones / therapeutic use
dc.subject.meshAdult
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshTomography, X-Ray Computed* / methods
dc.subject.meshTreatment Outcome
dc.subject.meshAntifungal Agents* / therapeutic use
dc.subject.meshAspergillosis, Allergic Bronchopulmonary* / diagnostic imaging
dc.subject.meshAspergillosis, Allergic Bronchopulmonary* / drug therapy
dc.subject.meshAsthma* / diagnostic imaging
dc.subject.meshAsthma* / drug therapy
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshItraconazole* / therapeutic use
dc.title.enCT Imaging Assessment of Response to Treatment in Allergic Bronchopulmonary Aspergillosis in Adults With Bronchial Asthma
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.chest.2024.02.026en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalChesten_US
bordeaux.page1307-1318en_US
bordeaux.volume165en_US
bordeaux.hal.laboratoriesCentre de Recherche Cardio-Thoracique de Bordeaux (CRCTB) - U1045en_US
bordeaux.issue6en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcehal
hal.identifierhal-04473459
hal.version1
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
workflow.import.sourcehal
dc.rights.ccPas de Licence CCen_US
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