1. role of chest CT in deciphering interstitial lung involvement: systemic sclerosis versus COVID-19.
- Author
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Orlandi, Martina, Landini, Nicholas, Sambataro, Gianluca, Nardi, Cosimo, Tofani, Lorenzo, Bruni, Cosimo, Bellando-Randone, Silvia, Blagojevic, Jelena, Melchiorre, Daniela, Hughes, Michael, Denton, Christopher P, Luppi, Fabrizio, Ruaro, Barbara, Casa, Francesca della, Rossi, Francesca W, Luca, Giacomo De, Campochiaro, Corrado, Spinicci, Michele, Zammarchi, Lorenzo, and Tomassetti, Sara
- Subjects
DISEASE progression ,VIRAL pneumonia ,RESEARCH ,CHEST X rays ,COVID-19 ,PREDICTIVE tests ,MULTIVARIATE analysis ,INTERSTITIAL lung diseases ,SYSTEMIC scleroderma ,LUNG tumors ,FIBROSIS ,COMPUTED tomography ,SENSITIVITY & specificity (Statistics) ,DISEASE complications - Abstract
Objective The aim of this study was to identify the main CT features that may help in distinguishing a progression of interstitial lung disease (ILD) secondary to SSc from COVID-19 pneumonia. Methods This multicentric study included 22 international readers grouped into a radiologist group (RADs) and a non-radiologist group (nRADs). A total of 99 patients, 52 with COVID-19 and 47 with SSc-ILD, were included in the study. Results Fibrosis inside focal ground-glass opacities (GGOs) in the upper lobes; fibrosis in the lower lobe GGOs; reticulations in lower lobes (especially if bilateral and symmetrical or associated with signs of fibrosis) were the CT features most frequently associated with SSc-ILD. The CT features most frequently associated with COVID- 19 pneumonia were: consolidation (CONS) in the lower lobes, CONS with peripheral (both central/peripheral or patchy distributions), anterior and posterior CONS and rounded-shaped GGOs in the lower lobes. After multivariate analysis, the presence of CONs in the lower lobes (P < 0.0001) and signs of fibrosis in GGOs in the lower lobes (P < 0.0001) remained independently associated with COVID-19 pneumonia and SSc-ILD, respectively. A predictive score was created that was positively associated with COVID-19 diagnosis (96.1% sensitivity and 83.3% specificity). Conclusion CT diagnosis differentiating between COVID-19 pneumonia and SSc-ILD is possible through a combination of the proposed score and radiologic expertise. The presence of consolidation in the lower lobes may suggest COVID-19 pneumonia, while the presence of fibrosis inside GGOs may indicate SSc-ILD. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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