Operator-independent quantitative chest computed tomography versus standard assessment of interstitial lung disease related to systemic sclerosis: A multi-centric study.
OBJECTIVE
Interstitial lung disease (ILD) related to systemic sclerosis (SSc) is assessed with pulmonary functional tests (PFTs) and semi-quantitative scores based on extent of ILD detectable on chest computed tomography (CT). CT quantitative indexes (QCTIs) are promising tools to assess extent of ILD. This study's aim is to evaluate the validity of QCTI compared with that of chest CT standard evaluation and PFTs. Moreover, QCTI differences between patients' subgroups according to prognostic stratifications were investigated.


METHODS
ILD-SSc of patients from six rheumatological clinics was routinely assessed with chest CT and PFTs. Patients were clustered according to prognosis based on functional and/or radiological examinations. Finally, chest CTs were processed with OsiriX in order to obtain QCTI.


RESULTS
Two hundred fifty-seven SSc patients were enrolled. QCTI correlation between extent of ILD and PFTs range from - 0.60 to 0.58 and from - 0.54 to 0.52, respectively. The majority of QCTI have a different distribution in patients' subgroups based on prognosis. Most of QCTI discriminate patients with an ILD severity leading to a poor prognosis.


CONCLUSIONS
QCTI assessment of ILD-SSc is comparable to the evaluation based on chest CT and/or PFTs. QCTI values corresponding to severe ILD were identified. QCTIs are excellent candidates for a new and more reliable SSc-ILD assessment.
a Department of Medicine , Internal Medicine and Rheumatology Unit, Azienda Ospedaliero- Universitaria di Parma , Parma , Italy.
Alarico
A
Ariani
Mario
M
Silva
Elena
E
Bravi
Marta
M
Saracco
Simone
S
Parisi
Fabio
F
De Gennaro
Federica
F
Lumetti
Luca
L
Idolazzi
Valeria
V
Seletti
Paola
P
Caramaschi
Camilla
C
Benini
Flavio Cesare
FC
Bodini
Carlo Alberto
CA
Scirè
Gianluca
G
Lucchini
Daniele
D
Santilli
Flavio
F
Mozzani
Davide
D
Imberti
Eugenio
E
Arrigoni
Giovanni
G
Delsante
Raffaele
R
Pellerito
Enrico
E
Fusaro
Nicola
N
Sverzellati
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012129:Respiratory Function Tests; D012595:Scleroderma, Systemic / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000379:methods*
CT indexes; CT quantitative assessment; Interstitial lung disease; OsiriX; Systemic sclerosis