Lung US Surface Wave Elastography in Interstitial Lung Disease Staging

Abstract

he prevalence of interstitial pulmonary fibrosis in the United States ranges from 14.0-27.9 and 42.7-63.0 cases per 100 000 people (using narrow and broad case definitions, respectively) (1). Accurate prognostic assessment facilitates identification of high-risk patients who may benefit from treatment. Pulmonary function tests (PFTs) have been used to develop a prognostic algorithm for interstitial lung disease (2). However, major constraints of PFTs include their wide range of normal values (80%-120% of the predicted value) and relative insensitivity for detecting early stage lung disease. To improve the accuracy of interstitial lung disease staging, high-resolution CT can be used to characterize and quantify the extent of disease (3-6), but this procedure requires exposure to ionizing radiation and can be expensive. Thus, high-resolution CT is not an ideal test for screening at-risk patients or evaluating those who may have early interstitial lung disease (7). Lung US has been increasingly used in the past decade for assessing lung disease (8-10). Its advantages over other imaging modalities are speed, ease of use, portability, absence of ionizing radiation, and low cost (11). Moreover, lung US surface wave elastography (SWE) is an emerging medical imaging technique that can noninvasively quantify lung surface stiffness by evaluating the rate of surface wave propagation (12). These preliminary studies suggest that lung surface wave speed, as measured by elastography, is a relevant biomarker of lung fibrosis. The purpose of this study was to examine the lung surface wave speed values for grading the severity of interstitial lung disease based on highresolution CT, PFT, and clinical assessments. Materials and Methods Our institutional review board approved this prospective study. All study subjects provided written informed consent.

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