Martina Orlandi1, Nicholas Landini2,3, Gianluca Sambataro4,5, Cosimo Nardi2, Lorenzo Tofani1, Cosimo Bruni1, Silvia Bellando-Randone1, Jelena Blagojevic1, Daniela Melchiorre1, Michael Hughes6, Christopher P Denton7, Fabrizio Luppi8, Barbara Ruaro9, Francesca Della Casa10, Francesca W Rossi10, Giacomo De Luca11, Corrado Campochiaro11, Michele Spinicci12, Lorenzo Zammarchi12, Sara Tomassetti13, Antonella Caminati14, Edoardo Cavigli15, Marco Albanesi15, Fabio Melchiorre16, Stefano Palmucci17, Virginia Vegni18, Serena Guiducci1, Alberto Moggi-Pignone19, Yannick Allanore20, Alessandro Bartoloni12, Marco Confalonieri9, Lorenzo Dagna11, Francesco DeCobelli21, Amato dePaulis10, Sergio Harari14,22, Dinesh Khanna23, Masataka Kuwana24, Gloria Taliani25, Federico Lavorini13, Vittorio Miele15, Giovanni Morana3, Alberto Pesci8, Carlo Vancheri4, Stefano Colagrande2, Marco Matucci-Cerinic1,11. 1. Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence. 2. Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-AOUC, Florence. 3. Department of Radiology, Ca' Foncello General Hospital, Treviso. 4. Regional Referral Centre for Rare Lung Diseases, A. O. U. 'Policlinico G. Rodolico-San Marco' Department of Clinical and Experimental Medicine, University of Catania. 5. Artroreuma SRL, Outpatient of Rheumatology Accredited with Italian National Health System, Mascalucia, Catania, Italy. 6. Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield. 7. University College London Division of Medicine, Centre for Rheumatology and Connective Tissue Diseases, London, UK. 8. Respiratory Unit, University of Milano-Bicocca, S. Gerardo Hospital, Monza. 9. Department of Pulmonology, University Hospital of Cattinara, Trieste. 10. Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli. 11. Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano. 12. Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC. 13. Department of Clinical and Experimental Medicine, University of Florence, Florence. 14. U.O. di Pneumologia, Ospedale San Giuseppe MultiMedica, IRCCS, Milano. 15. Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence. 16. Department of Radiology, Sant'Andrea Hospital Vercelli, ASLVC. 17. Radiodiagnostic and Radiotherapy Unit, Department of Medical Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania. 18. Radiology Unit, Rugani Hospital, Siena. 19. Department of Experimental and Clinical Medicine, AOU Careggi Hospital, University of Florence Medical School, Florence, Italy. 20. Department of Rheumatology A, Descartes University, APHP, Cochin Hospital, Paris, France. 21. Department of Radiology IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University. 22. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 23. Department of Medicine, University of Michigan, Ann Arbor, MI, USA. 24. Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan. 25. Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
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.
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.
Authors: Carmen Bobeica; Mihaela Craescu; Bogdan Ioan Stefanescu; Ciprian Dinu; Iulia Chiscop; Silvia Chirobocea; Luiza Nechita; Alina Viorica Iancu; Victorita Stefanescu; Gabriela Balan; Ioana Anca Stefanopol; Ana Maria Pelin; Elena Niculet; Carmina Liana Musat; Alin Laurentiu Tatu Journal: Int J Gen Med Date: 2022-04-26
Authors: Nicola Farina; Giovanni Benanti; Giacomo De Luca; Anna Palmisano; Giovanni Peretto; Sara Tomassetti; Veronica Giorgione; Ornella Forma; Antonio Esposito; Silvio Danese; Lorenzo Dagna; Marco Matucci-Cerinic; Corrado Campochiaro Journal: J Multidiscip Healthc Date: 2022-04-20
Authors: Verónica Pulito-Cueto; Sara Remuzgo-Martínez; Fernanda Genre; Belén Atienza-Mateo; Víctor M Mora-Cuesta; David Iturbe-Fernández; Leticia Lera-Gómez; Javier Rodriguez-Carrio; Diana Prieto-Peña; Virginia Portilla; Ricardo Blanco; Alfonso Corrales; Oreste Gualillo; José M Cifrián; Raquel López-Mejías; Miguel A González-Gay Journal: Biomedicines Date: 2022-04-05
Authors: Barbara Ruaro; Elisa Baratella; Paola Confalonieri; Marco Confalonieri; Fabio Giuseppe Vassallo; Barbara Wade; Pietro Geri; Riccardo Pozzan; Gaetano Caforio; Cristina Marrocchio; Maria Assunta Cova; Francesco Salton Journal: Diagnostics (Basel) Date: 2021-12-07
Authors: Barbara Ruaro; Francesco Salton; Elisa Baratella; Paola Confalonieri; Pietro Geri; Riccardo Pozzan; Chiara Torregiani; Roberta Bulla; Marco Confalonieri; Marco Matucci-Cerinic; Michael Hughes Journal: Diagnostics (Basel) Date: 2022-03-01