CT for CF
Hi-Res Imaging Used for Early Detection

FALL 2006 -- Early intervention is the key to prolonging the lives of children with cystic fibrosis (CF), says Packard pulmonologist Terry Robinson, MD.

Terry Robinson, MD, is using CT imaging to detect abnormalities in lung tissue of CF patients before their outward symptoms appear.

"At birth, CF patients have normal-looking lung tissue," he explains. "But as they grow older, tiny structural changes occur inside the lungs that are undetectable with x-rays exams and standard pulmonary function tests (PFTs)."

If these structural changes could be identified and treated in their early stages, then doctors might be able to slow the progression of the disease, he adds. To that end, Robinson and his colleagues at the Packard CF Clinic have turned to computed tomography, or CT imaging -- a diagnostic technique that allows researchers to examine minute, high-resolution images of the diseased lung without subjecting the patient to a biopsy or high levels of radiation.

In one recent Clinic study, CT imaging revealed that patients diagnosed with a supposedly mild form of CF were already experiencing bronchial wall thickening and bronchiectasis -- a widening of the airways caused by mucus blockage. These structural abnormalities can worsen over time and lead to diminished lung capacity and efficiency. But in the study, Robinson and his co-workers found that patients treated with antibiotics and other medications showed measurable improvements in their airways and bronchial tubes.

"These findings suggest that there is a critical period in the spectrum of chronic CF lung disease for reducing, and even reversing, lung tissue damage," Robinson says. "We need to develop new technologies to pick up abnormalities in the very young, including infants, because with early diagnosis and aggressive treatment, there's a good chance we can prevent some of the more serious effects of CF."