Detection of amiodarone-induced pulmonary toxicity in supine and prone positions - High-resolution computed tomography study

Background: The aim of the present study was to describe the effectiveness and feasibility of high-resolution computed tomography (HRCT) in patients in supine and prone positions to detect amiodarone-induced pulmonary toxicity (APT). With regard to the possible differential diagnosis, our second goal was to emphasize the clinical value of HRCT with the patients in supine and prone positions compared with other paraclinical tests. Methods and Results: Thoracic HRCT taken in both positions for 23 patients who were administrated amiodarone were prospectively evaluated in the current study. High-resolution computed tomography scans obtained with the patient in a prone position were helpful in differentiating dependent opacity from lung disease in 11 out of 23 patients. In another 4 patients, HRCT scans obtained with the patient in a prone position were useful in confirming the presence of subtle ground-glass opacities, considered as APT. Combination of HRCT in supine and prone positions provided a more reproducible method for evaluating the global extent of APT than other paraclinical tests. Conclusions: High-resolution computed tomography used in prone positions as well as a supine position could be an effective technique for reducing false-positive results in detection of APT and preventing the clinically serious pulmonary adverse effects by amiodanone.