THU0600 QUANTITATIVE INDEXES TO ASSESS THE INTERSTITIAL LUNG DISEASE, AND ITS EXTENSION, IN SJÖGREN'S SYNDROME. (June 2019)

• Record Type: Journal Article
• Authors: Guisado-Vasco, Pablo; Silva, Mario; Duarte-Millán, Miguel Angel; Sambataro, Gianluca; Bertolazzi, Chiara; Pavone, Mauro; Martín-Garrido, Isabel; Martín-Segarra, Oriol; Luque-Pinilla, José Manuel; Santilli, Daniele; Sambataro, Domenico; Torrisi, Sebastiano Emanuele; Ada, Vancheri; Gutierrez, Marwin; Mejia, Mayra; Palmucci, Stefano; Mozzani, Flavio; Rojas-Serrano, Jorge; Vanchieri, Carlo; Sverzellati, Nicola; Ariani, Alarico
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 592
• Page End: 592
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.3496
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Interstitial lung disease (ILD) is the most frequent pulmonary impairment in Sjögren's syndrome (SS). The diagnosis is challenging, as there are not specific tests (i.e. autoantibodies or pulmonary function tests) or symptoms. Chest CT is the gold standard. Semiquantitative visual scores (SQCT) estimate ILD extent, though burdened by relevant intra-, inter-rater variability. Quantitative chest CT (QCT) is a promising method to assess ILD severity Objectives: to verify if QCT assessment could identify SS subjects affected by ILD and to identify those SS patients with an extensive lung disease. Methods: in this multi-center, cross-sectional, and retrospective study, subjects affected by SS and with a chest CT were enrolled. A blind and centralized SQCT assessment was carried out in order to calculate both Goh and Taouli scores. An operator-independent analysis of all CTs with an open-source software (i.e. Horos), provided the QCT indexes. Patients were clustered in cohorts according to ILD extent. Differences in QCT indexes distribution were analyzed using non-parametric tests. Results: 102 consecutive SS patients were enrolled. ILD prevalence was 36% (36/102). There was a difference in QCT indexes' distribution in SS-ILD versus SS without ILD (p < 0.001). Moreover, SS-ILD patients with an ILD >20% (according to Goh score) had QCT indexes statistically different from those with a limited ILD extension (p<0.001). QCT indexes have a moderate to good correlation with Goh and Taouli scores (from 0.44 to 0.65; absolute numbers, +/-; p < 0.001). To value its potential of diagnosis, ROC curves were calculated, achieving several of them values of AUC > 0.7; the best QTC index was: tSkew AUC 0.87 (95CI 0.78-0.95), p< 0.001; cut-off ≤ 2.72 - sensitivity 0.81 (95CI 0.65-0.9), specificity 0.82 (95CI 0.7-0.89). Conclusion: QCT indexes are a serious alternative to visual scorings in ILD related to autoimmune diseases. This innovative tool will open up a potential research area in SS as it appears able to select ILD patients with an extensive lung impairment and likewise a worse prognosis. We are confident that in the next future, QCT will have a pivotal role in the diagnosis, monitoring and treatment pathway of ILD associated to SS. References: [1] Silva M, Milanese G, Seletti V, Ariani A, Sverzellati N. Pulmonary quantitative CT imaging in focal and diffuse disease: current research and clinical applications. Br J Radiol2018; 91: 20170644. Disclosure of Interests: None declared