Quantitative chest computed tomography is associated with two prediction models of mortality in interstitial lung disease related to systemic sclerosis

Ariani, Alarico; Silva, Mario; Seletti, Valeria; Bravi, Elena; Saracco, Marta; Parisi, Simone; Gennaro, Fabio De; Idolazzi, Luca; Caramaschi, Paola; Benini, Camilla; Bodini, Flavio Cesare; Scirè, Carlo Alberto; Carrara, Greta; Lumetti, Federica; Alfieri, Veronica; Bonati, Elisa; Lucchini, G.; Aiello, Marina; Santilli, Daniele; Mozzani, Flavio; Imberti, Davide; Michieletti, Emanuele; Arrigoni, Eugenio; Delsante, Giovanni; Pellerito, Raffaele; Fusaro, Enrico; Chetta, Alfredo; Sverzellati, Nicola

doi:10.1093/rheumatology/kew480

Cited by 35 publications

(18 citation statements)

References 14 publications

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“…Quantitative methods overcome the inter-observer grade of concordance, but are not able to distinguish the main feature of lung damage. Moreover, both semiquantitative and quantitative methods were associated with mortality and PFTs at baseline [25][26][27], but this correlation was not always confirmed in the follow-up. A possible explanation is that a reduction in the total amount of GGOs, with a consequent increase in the proportion of HC, could not change quantitative values, but it is associated with an impairment of PFTs.…”

Section: Discussionmentioning

confidence: 92%

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Sambataro

Pignataro³

et al. 2020

Diagnostics

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Interstitial lung disease (ILD) is the main cause of death in systemic sclerosis (SSc) patients. Usually, patients have lung involvement characterized by ground glass opacities (GGOs), but honeycombing (HC) is also possible. The Wells score is a semi-quantitative index, which is able to assess ILD by distinguishing its main components. The aim of this work is to evaluate the Wells score in relation to the disease activity (DA) index. We enrolled 40 consecutive SSc-ILD patients (26 diffuse cutaneous form, dcSSc, and 14 limited form, lcSSc). All patients were evaluated by the European Scleroderma Study Group (ESSG) index, high-resolution computed tomography, transthoracic echocardiogram, pulmonary function tests (PTSs), and nailfold videocapillaroscopy for the number of microhemorrhages (NEMO) score. In our study, the total extent of ILD (TE-ILD), fibrosis and GGOs correlated with dyspnea (p = 0.03, 0.01 and 0.01 respectively), but not with the ESSG index. Considering only the dcSSc patients, TE-ILD and GGOs correlated with the ESSG index (r = 0.5 p = 0.009), while fibrosis grade correlated with disease duration and systolic pulmonary artery pressure. In conclusion, our data suggest that GGO correlates with DA, while fibrosis may be a sign of disease damage. The quantification of pulmonary involvement using the Wells score can be a useful tool for assessing the appropriate treatment in SSc patients.

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Section: Discussionmentioning

confidence: 92%

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Sambataro

Pignataro³

et al. 2020

Diagnostics

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“…HRCT may also be useful as a prognostic factor in the assessment of ILD severity and progression. Emerging evidences support the role of many quantification scores in the evaluation of prognosis and response to treatment in several CTDs [132][133][134].…”

Section: First-line Instrumental Examsmentioning

confidence: 94%

Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them?

Sambataro

Pignataro³

et al. 2020

Diagnostics

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The diagnostic assessment of patients with Interstitial Lung Disease (ILD) can be challenging due to the large number of possible causes. Moreover, the diagnostic approach can be limited by the severity of the disease, which may not allow invasive exams. To overcome this issue, the referral centers for ILD organized Multidisciplinary Teams (MDTs), including physicians and experts in complementary discipline, to discuss the management of doubtful cases of ILD. MDT is currently considered the gold standard for ILD diagnosis, but it is not often simple to organize and, furthermore, rheumatologists are still not always included. In fact, even if rheumatologic conditions represent a common cause of ILD, they are sometimes difficult to recognize, considering the variegated clinical features and their association with all possible radiographic patterns of ILD. The first objective of this review is to describe the clinical, laboratory, and instrumental tests that can drive a diagnosis toward a possible rheumatic disease. The secondary objective is to propose a set of first-line tests to perform in all patients in order to recognize any possible rheumatic conditions underlying ILD.

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“…137 Several studies showed that QCT is an objective analysis that may overcome the issue of the interobserver variability and could provide more consistent prognostic indexes. [138][139][140][141][142] Furthermore, QCT has the potential ability to identify CT features that are not visually recognizable and to objectively monitor the disease progression on serial CT scans.…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

“…systemic sclerosis). 141,142,145,146,150,156,158 At present, automated image analysis of ILD is still confined to the research setting.…”

Section: State Of the Artmentioning

confidence: 99%

“…153 Likewise, the histogram metrics can discriminate between well-defined different mortality risk categories in subjects with systemic sclerosis-related ILD. 142 Jacob showed that baseline texture-based CT quantification of total disease extent or individual patterns were superior to visual scoring in increasing the accuracy of clinicofunctional models predictive of outcome in IPF. 138 Intriguingly, the authors showed that the pulmonary vessels volume (PVV), was the individual QCT metric more strongly associated with mortality.…”

Section: State Of the Artmentioning

confidence: 99%

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Pulmonary quantitative CT imaging in focal and diffuse disease: current research and clinical applications

Silva

Milanese

Seletti

et al. 2018

The British Journal of Radiology

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The frenetic development of imaging technology-both hardware and software-provides exceptional potential for investigation of the lung. In the last two decades, CT was exploited for detailed characterization of pulmonary structures and description of respiratory disease. The introduction of volumetric acquisition allowed increasingly sophisticated analysis of CT data by means of computerized algorithm, namely quantitative CT (QCT). Hundreds of thousands of CTs have been analysed for characterization of focal and diffuse disease of the lung. Several QCT metrics were developed and tested against clinical, functional and prognostic descriptors. Computer-aided detection of nodules, textural analysis of focal lesions, densitometric analysis and airway segmentation in obstructive pulmonary disease and textural analysis in interstitial lung disease are the major chapters of this discipline. The validation of QCT metrics for specific clinical and investigational needs prompted the translation of such metrics from research field to patient care. The present review summarizes the state of the art of QCT in both focal and diffuse lung disease, including a dedicated discussion about application of QCT metrics as parameters for clinical care and outcomes in clinical trials.

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Quantitative chest computed tomography is associated with two prediction models of mortality in interstitial lung disease related to systemic sclerosis

Abstract: QCT assessment of SSc-ILD can discriminate between well-defined different mortality risk categories, supporting its prognostic value. These findings, together with the operator independence, strengthen the validity and clinical usefulness of QCT for assessment of SSc-ILD.

Cited by 35 publications

References 14 publications

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them?

Pulmonary quantitative CT imaging in focal and diffuse disease: current research and clinical applications

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