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Screening for interstitial lung disease in systemic sclerosis: performance of high-resolution CT with limited number of slices: a prospective study.
- Source :
-
Annals of the rheumatic diseases [Ann Rheum Dis] 2014 Dec; Vol. 73 (12), pp. 2069-73. Date of Electronic Publication: 2014 Sep 30. - Publication Year :
- 2014
-
Abstract
- Objectives: Early diagnosis of interstitial lung disease (ILD), currently the main cause of death in systemic sclerosis (SSc), is needed. The gold standard is high-resolution CT (HRCT) of the chest, but regular screening faces the risk of increased radiation exposure. We performed a prospective validation of a dedicated, 9-slice HRCT protocol with reduced radiation dose for the detection of ILD in patients with SSc.<br />Methods: We analysed 170/205 consecutive patients with SSc. Whole-chest HRCT, serving as standard of reference, and the reduced HRCT with nine slices allocated according to a basal-apical gradient were obtained. ILD presence, extent (> or <20%) and diagnostic confidence were assessed. The reduced HRCT was independently analysed by two blinded radiologists, who also evaluated image quality. Radiation dose parameters were calculated.<br />Results: Standard chest HRCT showed ILD in 77/170 patients. With the reduced HRCT, 68/77 cases with ILD were identified (sensitivity 88.3%, both readers). The accuracy (91.8%, reader 1; 94.7%, reader 2), diagnostic confidence (98.8%, reader 1; 95.3%, reader 2) and image quality rates were high. Minimal ILD was correctly quantified in 73.1% (reader 1)/71.2% (reader 2) and extensive ILD in 88% (reader 1)/100% (reader 2). Importantly, the reduced HRCT had a significantly lower radiation dose. The mean dose length product (effective dose) was only 5.66±4.46 mGycm (0.08±0.06 mSv) compared with the standard protocol dose of 149.00±95.90 mGycm (2.09±1.34 mSv).<br />Conclusions: The above-described reduced chest HRCT protocol reliably detects even mild SSc-ILD in clinical practice, with the advantage of a much lower radiation dose compared with standard whole-chest HRCT.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Subjects :
- Aged
Cohort Studies
Early Diagnosis
Female
Humans
Image Processing, Computer-Assisted
Lung Diseases, Interstitial etiology
Male
Mass Screening
Middle Aged
Prospective Studies
Radiation Dosage
Scleroderma, Systemic complications
Sensitivity and Specificity
Lung Diseases, Interstitial diagnostic imaging
Multidetector Computed Tomography methods
Scleroderma, Systemic diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2060
- Volume :
- 73
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Annals of the rheumatic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 25269829
- Full Text :
- https://doi.org/10.1136/annrheumdis-2014-205637