1. Thoracic ultrasound combined with low-dose computed tomography may represent useful screening strategy in highly exposed population in the industrial city of Taranto (Italy)
- Author
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Quarato, C, Dama, E, Maggi, M, Feragalli, B, Borelli, C, Del Colle, A, Taurchini, M, Maiello, E, De Cosmo, S, Lacedonia, D, Barbaro, M, Carpagnano, G, Scioscia, G, Graziano, P, Termine, R, Frongillo, E, Santamaria, S, Venuti, M, Grimaldi, M, Notarangelo, S, Saponara, A, Copetti, M, Colangelo, T, Cuttano, R, Macrodimitris, D, Mazzarelli, F, Talia, M, Mirijello, A, Pazienza, L, Perna, R, Simeone, A, Vergara, D, Varriale, A, Carella, M, Bianchi, F, Sperandeo, M, Quarato, Carla Maria Irene, Dama, Elisa, Maggi, Michele, Feragalli, Beatrice, Borelli, Cristina, Del Colle, Anna, Taurchini, Marco, Maiello, Evaristo, De Cosmo, Salvatore, Lacedonia, Donato, Barbaro, Maria Pia Foschino, Carpagnano, Giovanna Elisiana, Scioscia, Giulia, Graziano, Paolo, Termine, Rosalinda, Frongillo, Elisabettamaria, Santamaria, Sonia, Venuti, Mariapia, Grimaldi, Maria Arcangela, Notarangelo, Stefano, Saponara, Annarita, Copetti, Massimiliano, Colangelo, Tommaso, Cuttano, Roberto, Macrodimitris, Dimitrios, Mazzarelli, Francesco, Talia, Michela, Mirijello, Antonio, Pazienza, Luca, Perna, Rita, Simeone, Anna, Vergara, Doriana, Varriale, Antonio, Carella, Massimo, Bianchi, Fabrizio, Sperandeo, Marco, Quarato, C, Dama, E, Maggi, M, Feragalli, B, Borelli, C, Del Colle, A, Taurchini, M, Maiello, E, De Cosmo, S, Lacedonia, D, Barbaro, M, Carpagnano, G, Scioscia, G, Graziano, P, Termine, R, Frongillo, E, Santamaria, S, Venuti, M, Grimaldi, M, Notarangelo, S, Saponara, A, Copetti, M, Colangelo, T, Cuttano, R, Macrodimitris, D, Mazzarelli, F, Talia, M, Mirijello, A, Pazienza, L, Perna, R, Simeone, A, Vergara, D, Varriale, A, Carella, M, Bianchi, F, Sperandeo, M, Quarato, Carla Maria Irene, Dama, Elisa, Maggi, Michele, Feragalli, Beatrice, Borelli, Cristina, Del Colle, Anna, Taurchini, Marco, Maiello, Evaristo, De Cosmo, Salvatore, Lacedonia, Donato, Barbaro, Maria Pia Foschino, Carpagnano, Giovanna Elisiana, Scioscia, Giulia, Graziano, Paolo, Termine, Rosalinda, Frongillo, Elisabettamaria, Santamaria, Sonia, Venuti, Mariapia, Grimaldi, Maria Arcangela, Notarangelo, Stefano, Saponara, Annarita, Copetti, Massimiliano, Colangelo, Tommaso, Cuttano, Roberto, Macrodimitris, Dimitrios, Mazzarelli, Francesco, Talia, Michela, Mirijello, Antonio, Pazienza, Luca, Perna, Rita, Simeone, Anna, Vergara, Doriana, Varriale, Antonio, Carella, Massimo, Bianchi, Fabrizio, and Sperandeo, Marco
- Abstract
Objectives: We validated a screening protocol in which thoracic ultrasound (TUS) acts as a first-line complementary imaging technique in selecting patients which may deserve a second-line low-dose high resolution computed tomography (HRCT) scan among a population of asymptomatic high-risk subjects for interstitial lung abnormalities (ILA) and lung cancer. Due to heavy environmental pollution burden, the district Tamburi of Taranto has been chosen as “case study” for this purpose. Methods: From July 2018 to October 2020, 677 patients aged between 45 and 65 year and who had been living in the Tamburi district of Taranto for at least 10 years were included in the study. After demographic, clinical and risk factor exposition data were collected, each participant underwent a complete TUS examination. These subjects were then asked to know if they agreed to perform a second-level examination by low-dose HRCT scan. Results: On a total of 167 subjects (24.7%) who agreed to undergo a second-level HRCT, 85 patients (50.9%) actually showed pleuro-pulmonary abnormalities. Interstitial abnormalities were detected in a total of 36 patients on HRCT scan. In particular, 34 participants presented subpleural ILAs, that were classified in the fibrotic subtype in 7 cases. The remaining 2 patients showed non-subpleural interstitial abnormalities. Subpleural nodules were observed in 46 patients. TUS showed an overall diagnostic accuracy of 88.6% in detecting pleuro-pulmonary abnormalities in comparison with HRCT scan, with a sensitivity of 95.3%, a specificity of 81.7%, a positive predictive value of 84.4% and a negative predictive value of 94.4%. The matched evaluation of specific pulmonary abnormalities on HRTC scan (i.e., interstitial abnormalities or pulmonary nodules) with determinate sonographic findings revealed a reduction in both TUS sensibility and specificity. Focusing TUS evaluation on the assessment of interstitial abnormalities, a thickened pleural line showed a sensitivity
- Published
- 2023