99mTc-MIBI Lung Scintigraphy in the Assessment of Pulmonary Involvement in Interstitial Lung Disease and Its Comparison With Pulmonary Function Tests and High-Resolution Computed Tomography

Background:Dermatomyositis is a multi organ autoimmune disease wich is commonly complicated with interstitial lung disease. Chest high-resolution computed tomography (HRCT) is still considered the diagnostic gold standard for interstitial lung disease and is quantification, however he increasing use of lung ultrasound may play an important role in the future.Objectives:The aim of our study was to determine the diagnostic value of lung ultrasound in the detection and progression of interstitial pulmonary disease in patients with dermatomyositis.Methods:Twenty two subjects with dermatomyositis diagnosed according to the American College of Rheumatology criteria were enrolled (6 males, 16 females; mean age: 15,8 ± 8.8 years; range: 6 to 29 years). All subjects underwent high resolution computed tomography followed by transthoracic ultrasound for comet tail sign detection and pleural irregularity in order to predict the degree of interstitial lung disease. The modified transthoracic ultrasound assessment was performed at 06 thoracic regions each side. The Warrick score was calculated according standard high-resolution chest computed tomography images that were evaluated independently from each other by two thoracics radiologists.Results:A significantly positive correlation between transthoracic ultrasound and the severity of pulmonary involvement, as seen by the number of B lines (Spearman ‘s correlation coefficient = 0.80, p < 0.001), and the number of positive areas (regions wih more than 3 B lines) (Spearman ‘s correlation coefficient = 0.75, p < 0.001) were found. When compared with high-resolution chest computed tomography as the gold standard method, the sensitivity, specificity, of transthoracic ultrasound was 96.4%, 83,3% respectively. Addicionally the number of B lines (sum of 35 or more B lines) and a number of B lines positive areas (7 or more regions with at least 3 B lines) cut of allowed to discriminate the inflamatory pattern (ground glass) to those with structural pattern (honeycomb and pulmonary cysts).Conclusion:Our study showed that transthoracic ultrasound comet tails scoring system could be useful in the assessment of the pulmonary involvement in patients with dermatomyositis, and should be considered as a primary screening exam to exclude lung involvement, rather than routine chest CT scans in assimptomatic patients.Disclosure of Interests:None declared

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Evolution of Pulmonary Function in a Cohort of Patients with Interstitial Lung Disease and Positive for Antisynthetase Antibodies

The Journal of Rheumatology ◽

10.3899/jrheum.181141 ◽

2019 ◽

Vol 47 (3) ◽

pp. 415-423 ◽

Cited By ~ 6

Author(s):

Montserrat Ixchel González-Pérez ◽

José Guillermo Mejía-Hurtado ◽

Diana Isabel Pérez-Román ◽

Ivette Buendía-Roldán ◽

Mayra Mejía ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Interstitial Lung Disease ◽

Pulmonary Function ◽

Medical Treatment ◽

Lung Disease ◽

Ground Glass ◽

High Resolution Computed Tomography ◽

High Extent ◽

Antisynthetase Antibodies

Objective.To describe the evolution of the pulmonary function in patients with interstitial lung disease (ILD) who are positive for at least 1 of the antisynthetase antibodies (ASAB) after medical treatment, and to compare whether the evolution of pulmonary function is associated with the type of ASAB.Methods.Patients with ILD and positive for at least 1 of the ASAB (anti-Jo1, anti-PL7, anti-PL12, anti-EJ, or anti-OJ) were included. The clinical evolution, time until death or censoring, and improvement of lung disease were registered.Results.The study included 118 patients. Most of the patients had a high extent of ground glass opacities in high-resolution computed tomography (HRCT) and low extent of fibrosis. In the final evaluation of pulmonary function (median 749.5 days of followup), 67% of the patients had lung disease improvement. The improvement occurred within the first 6 months after initiating medical treatment; thereafter, pulmonary function remained stable in most of the patients. A decrease of the extent of ground glass opacities was demonstrated in HRCT at followup in those patients with pulmonary improvement. No differences were observed in the percentage of patients who achieved improvement between the ASAB groups, or in survival.Conclusion.Improvement of pulmonary function was observed in 67% of the patients. Improvement was observed in all ASAB groups and occurred within 6 months after initiating medical treatment.

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Computer-Aided Quantification of Interstitial Lung Disease from High Resolution Computed Tomography Images in Systemic Sclerosis: Correlation with Visual Reader-Based Score and Physiologic Tests

BioMed Research International ◽

10.1155/2015/834262 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Fausto Salaffi ◽

Marina Carotti ◽

Silvia Bosello ◽

Alessandro Ciapetti ◽

Marwin Gutierrez ◽

...

Keyword(s):

Computed Tomography ◽

Systemic Sclerosis ◽

High Resolution ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Pulmonary Function Tests ◽

Linear Regression Analysis ◽

Receiver Operating Curve ◽

High Resolution Computed Tomography ◽

Computed Tomography Images

Objective.To evaluate the performance of a computerized-aided method (CaM) for quantification of interstitial lung disease (ILD) in patients with systemic sclerosis and to determine its correlation with the conventional visual reader-based score (CoVR) and the pulmonary function tests (PFTs).Methods.Seventy-nine patients were enrolled. All patients underwent chest high resolution computed tomography (HRCT) scored by two radiologists adopting the CoVR. All HRCT images were then analysed by a CaM using a DICOM software. The relationships among the lung segmentation analysis, the readers, and the PFTs results were calculated using linear regression analysis and Pearson’s correlation. Receiver operating curve analysis was performed for determination of CaM extent threshold.Results.A strong correlation between CaM and CoVR was observed (P<0.0001). The CaM showed a significant negative correlation with forced vital capacity (FVC) (P<0.0001) and the single breath carbon monoxide diffusing capacity of the lung (DLco) (P<0.0001). A CaM optimal extent threshold of 20% represented the best compromise between sensitivity (75.6%) and specificity (97.4%).Conclusions.CaM quantification of SSc-ILD can be useful in the assessment of extent of lung disease and may provide reliable tool in daily clinical practice and clinical trials.

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Interstitial lung disease in systemic sclerosis quantification of disease classification and progression with high-resolution computed tomography: An observational study

Journal of Scleroderma and Related Disorders ◽

10.1177/2397198320985377 ◽

2021 ◽

pp. 239719832098537

Author(s):

Johan Clukers ◽

Maarten Lanclus ◽

Dennis Belmans ◽

Cedric Van Holsbeke ◽

Wilfried De Backer ◽

...

Keyword(s):

Computed Tomography ◽

Systemic Sclerosis ◽

Interstitial Lung Disease ◽

Pulmonary Function ◽

Lung Disease ◽

Pulmonary Function Tests ◽

Severe Disease ◽

Quantitative Computed Tomography ◽

High Resolution Computed Tomography ◽

Function Tests

Introduction: Systemic sclerosis–associated interstitial lung disease accounts for up to 20% of mortality in these patients and has a highly variable prognosis. Functional respiratory imaging, a quantitative computed tomography imaging technique which allows mapping of regional information, can provide a detailed view of lung structures. It thereby shows potential to better characterize this disease. Purpose: To evaluate the use of functional respiratory imaging quantitative computed tomography in systemic sclerosis–associated interstitial lung disease staging, as well as the relationship between short-term changes in pulmonary function tests and functional respiratory imaging quantitative computed tomography with respect to disease severity. Materials and methods: An observational cohort of 35 patients with systemic sclerosis was retrospectively studied by comparing serial pulmonary function tests and in- and expiratory high-resolution computed tomography over 1.5-year interval. After classification into moderate to severe lung disease and limited lung disease (using a hybrid method integrating quantitative computed tomography and pulmonary function tests), post hoc analysis was performed using mixed-effects models and estimated marginal means in terms of functional respiratory imaging parameters. Results: At follow-up, relative mean forced vital capacity percentage change was not significantly different in the limited (6.37%; N = 13; p = 0.053) and moderate to severe disease (−3.54%; N = 16; p = 0.102) groups, respectively. Specific airway resistance decreased from baseline for both groups. (Least square mean changes −25.11% predicted ( p = 0.006) and −14.02% predicted ( p = 0.001) for limited and moderate to severe diseases.) In contrast to limited disease from baseline, specific airway radius increased in moderate to severe disease by 8.57% predicted ( p = 0.011) with decline of lower lobe volumes of 2.97% predicted ( p = 0.031). Conclusion: Functional respiratory imaging is able to differentiate moderate to severe disease versus limited disease and to detect disease progression in systemic sclerosis.

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AB0605 CLINICAL PROFILE AND CHEST HIGH-RESOLUTION COMPUTED TOMOGRAPHY (HRCT) FINDINGS IN PATIENTS WITH CONNECTIVE TISSUE DISEASES AND INTERSTITIAL LUNG DISEASE: EXPERIENCE OF A SINGLE REFERENCE RHEUMATOLOGY CENTER

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3758 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1598.2-1599

Author(s):

I. Rusu ◽

L. Muntean ◽

M. M. Tamas ◽

I. Felea ◽

L. Damian ◽

...

Keyword(s):

Computed Tomography ◽

Systemic Sclerosis ◽

High Resolution ◽

Interstitial Lung Disease ◽

Connective Tissue ◽

Lung Disease ◽

Interstitial Pneumonia ◽

Connective Tissue Diseases ◽

High Resolution Computed Tomography ◽

Hrct Patterns

Background:Interstitial lung disease (ILD) is a common manifestation of connective tissue diseases (CTDs), and is associated with significant morbidity and mortality. Chest high-resolution computed tomography (HRCT) play an important role in the diagnosis of ILD and may provide prognostic information.Objectives:We aimed to characterize the clinical profile and chest HRCT abnormalities and patterns of patients diagnosed with CTDs and ILD.Methods:In this retrospective, observational study we included 80 consecutive patients with CTDs and ILD referred to a tertiary rheumatology center between 2015 and 2019. From hospital charts we collected clinical data, immunologic profile, chest HRCT findings. HRCT patterns were defined according to new international recommendations.Results:Out of 80 patients, 64 (80%) were women, with a mean age of 55 years old. The most common CTD associated with ILD was systemic sclerosis (38.8%), followed by polymyositis (22.5%) and rheumatoid arthritis (18.8%). The majority of patients had dyspnea on exertion (71.3%), bibasilar inspiratory crackles were present in 56.3% patients and 10% had clubbing fingers. Antinuclear antibodies (ANA) were present in 78.8% patients, and the most frequently detected autoantibodies against extractable nuclear antigen were anti-Scl 70 (28.8%), followed by anti-SSA (anti-Ro, 17.5%), anti-Ro52 (11.3%) and anti-Jo (7.5%). Intravenous cyclophosphamide therapy for 6-12 months was used in 35% of patients, while 5% of patients were treated with mycophenolate mofetil.The most frequent HRCT abnormalities were reticular abnormalities and ground glass opacity. Non-specific interstitial pneumonia (NSIP) was identified in 46.3% CTDs patients. A pattern suggestive of usual interstitial pneumonia (UIP) was present in 32.5% patients, mainly in patients with systemic sclerosis. In 21.3% patients the HRCT showed reticulo-nodular pattern, micronodules and other abnormalities, not diagnostic for UIP or NSIP pattern.Conclusion:Nonspecific interstitial pneumonia (NSIP) is the most common HRCT pattern associated with CTDs. Further prospective longitudinal studies are needed in order to determine the clinical and prognostic significance of various HRCT patterns encountered in CTD-associated ILD and for better patient management.References:[1]Ohno Y, Koyama H, Yoshikaua T, Seki S. State-of-the-Art Imaging of the Lung for Connective Tissue Disease (CTD). Curr Rheumatol Rep. 2015;17(12):69.[2]Walsh SLF, Devaraj A, Enghelmeyer JI, Kishi K, Silva RS, Patel N, et al. Role of imaging in progressive-fibrosing interstitial lung diseases. Eur Respir Rev. 2018;27(150)Disclosure of Interests:None declared

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