The predictive role of lung ultrasound in progression of scleroderma interstitial lung disease

Gasperini, Maria Ludovica; Gigante, Antonietta; Iacolare, Andrea; Pellicano, Chiara; Lucci, S; Rosato, Edoardo

doi:10.1007/s10067-019-04686-z

Cited by 30 publications

(42 citation statements)

References 14 publications

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“…Despite many technical differences (convex/linear and 2.5-10 MHz probes; scanning protocols considering 72-10 intercostal spaces; scoring systems; pathological B-lines cut-off), [43][44][45][46][47][48][49][50][53][54][55][56][57][58][59][60] LUS provides significant positive correlations between B-lines and HRCT findings and, less commonly, between B-lines and vascular damage (capillaroscopic pattern and number of digital ulcers). 45,50 Literature data also describe a similar correlation between pleural line alterations ('US' thickness > 3 mm or irregularities) and HRCT, probably allowing a better discrimination than B-lines in ILD detection. 47,54,[58][59][60] Therefore, a negative correlation has been demonstrated between B-lines and PFT (DLCO and forced vital capacity).…”

Section: Clinical Applications and Future Perspectivesmentioning

confidence: 99%

“…47,54,58–60 Therefore, a negative correlation has been demonstrated between B-lines and PFT (DLCO and forced vital capacity). 43,45,46,48 The potential prognostic utility was explored by Gasparini et al, 50 who showed that basal B-lines predict DLCO change after 12 months and by Gargani et al, 52 who demonstrated that a higher number of B-lines is associated with worsening or development of pulmonary involvement.…”

Section: Lungmentioning

confidence: 99%

“…42 Our current approach to the assessment of SSc-ILD, which includes plain chest radiography, pulmonary auscultation and pulmonary function tests (PFT), is insensitive to detect early ILD. Therefore, as an effort to fulfil this gap, many authors have proposed Adapted from Hughes et al 32 LUS as an imaging technique that is able to assess SSc-ILD, [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] even in the earliest stages. 49,51 Preliminary studies have demonstrated reasonable correlation between LUS and HRCT findings in the detection of ILD in established patients with SSc.…”

Section: Introductionmentioning

confidence: 99%

“…53,61 The utility of LUS in the diagnosis of ILD in very early SSc 55 and more recently, its potential for the detection of SSc-ILD in asymptomatic preclinical stages 51 have also been described. Recent research has been focused on the predictive value of LUS, 50,52 which is opening new perspectives for the application of US as a screening method for SSc-ILD in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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The role of ultrasound in systemic sclerosis: On the cutting edge to foster clinical and research advancement

Hughes

Bruni

Cuomo³

et al. 2020

Journal of Scleroderma and Related Disorders

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Ultrasound has been widely explored in systemic sclerosis in the clinical and research settings. Ultrasound allows a non-invasive and ionising radiation-free ‘window’ into this complex disease and is well-suited to repeated examinations. Ultrasound provides novel insights into the pathogenesis and measurement of disease in systemic sclerosis, including early (preclinical) internal organ involvement. The purpose of this review is to describe the role of ultrasound to foster clinical and research advancements in systemic sclerosis relating to (1) musculoskeletal, (2) digital ulcer, (3) lung disease and (4) skin disease. We also highlight unmet needs which much be addressed for ultrasound to assume a central role in systemic sclerosis clinical care and research.

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Section: Clinical Applications and Future Perspectivesmentioning

confidence: 99%

Section: Lungmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of ultrasound in systemic sclerosis: On the cutting edge to foster clinical and research advancement

Hughes

Bruni

Cuomo³

et al. 2020

Journal of Scleroderma and Related Disorders

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“…6 Citation: Manfredi Despite the potentially deep impact of lung involvement on clinical course and prognosis, a routine assessment of ILD is not properly defined for all CTDs. It is probably better defined in patients with systemic sclerosis (SSc), 7 while it is not so common for other CTDs, such as primitive Sjögren's syndrome (SS) or systemic lupus erythematosus (SLE) that can also be complicated by ILD. 1,[8][9][10] Moreover, increasing data suggest a higher prevalence than expected of severe ILD, also in CTDs other than SSc; nevertheless, the absence of a routine screening for ILD can frequently delay the diagnosis.…”

mentioning

confidence: 99%

Usefulness of Digital Velcro Crackles Detection in Identification of Interstitial Lung Disease in Patients With Connective Tissue Diseases

Manfredi¹,

Cassone²,

Vacchi³

et al. 2020

Arch Rheumatol

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Objectives This study aims to evaluate the diagnostic accuracy of the VECTOR software in patients with connective tissue diseases (CTDs), compared with the reference standard of high-resolution computed tomography (HRCT). Patients and methods The study included 98 consecutive patients of CTD (24 males, 74 females; median age 66 years; range, 24 to 85 years) with a recent HRCT. Patients were evaluated in a blindly manner by VECTOR and the results obtained by the algorithm were compared with the presence of interstitial lung disease (ILD) according to HRCT. Results Interstitial lung disease was detected in 42.8% of subjects. VECTOR correctly classified 81/98 patients, with a diagnostic accuracy of 82.6%; sensitivity and specificity were 88.1% and 78.6%, respectively. Only 5/42 patients with ILD were not correctly classified by VECTOR, while false positive cases were 21.4%. No significant differences were observed according to the radiologic pattern of ILD. Conclusion VECTOR showed high sensitivity, specificity and diagnostic accuracy, allowing selecting patients to be investigated with HRCT. The relatively high frequency rate of false positive results is acceptable if compared with the lack of effective screening methods for this complication of CTDs.

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A Composite Serum Biomarker Index for the Diagnosis of Systemic Sclerosis–Associated Interstitial Lung Disease: A Multicenter, Observational Cohort Study

Jee

Stewart

Youssef

et al. 2023

Arthritis & Rheumatology

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Objective In patients with systemic sclerosis (SSc), we investigated composite serum biomarker panels for the diagnosis and risk stratification of SSc–associated interstitial lung disease (SSc‐ILD). Methods We analyzed 28 biomarkers in 640 participants: 259 patients with SSc‐ILD and 179 SSc patients without ILD (Australian Scleroderma Cohort Study), 172 patients with idiopathic pulmonary fibrosis (IPF‐controls) (Australian IPF Registry), and 30 healthy controls. A composite index was developed from biomarkers associated with ILD in multivariable analysis derived at empirical thresholds. We evaluated the performance of the index to identify ILD, and specifically SSc‐ILD, and its association with lung function, disease extent on radiography, and patient health–related quality of life in derivation and validation cohorts. Biomarkers to distinguish SSc‐ILD from IPF‐controls were identified. Results A composite biomarker index, comprising surfactant protein D (SP‐D), Ca15‐3, and intercellular adhesion molecule 1 (ICAM‐1), was strongly associated with SSc‐ILD diagnosis, independent of age, sex, smoking history, and lung function (for biomarker index score 3, pooled adjusted odds ratio was 12.72 (95% confidence interval 4.59–35.21) (P < 0.001). The composite index strengthened the performance of individual biomarkers for SSc‐ILD identification. In SSc patients, a higher index was associated with worse baseline disease severity (for biomarker index score 3 relative to biomarker index score 0, the adjusted absolute change in forced vital capacity percent predicted was −17.84% and the diffusing capacity for carbon monoxide percent predicted was −20.16%; both P < 0.001). Conclusion A composite serum biomarker index, comprising SP‐D, Ca15‐3, and ICAM‐1, may improve the identification and risk stratification of ILD in SSc patients at baseline.

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The predictive role of lung ultrasound in progression of scleroderma interstitial lung disease

Cited by 30 publications

References 14 publications

The role of ultrasound in systemic sclerosis: On the cutting edge to foster clinical and research advancement

The role of ultrasound in systemic sclerosis: On the cutting edge to foster clinical and research advancement

Usefulness of Digital Velcro Crackles Detection in Identification of Interstitial Lung Disease in Patients With Connective Tissue Diseases

A Composite Serum Biomarker Index for the Diagnosis of Systemic Sclerosis–Associated Interstitial Lung Disease: A Multicenter, Observational Cohort Study

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