Systemic sclerosis interstitial lung disease evaluation: comparison between semiquantitative and quantitative...

Area of Science:

• Radiology
• Pulmonology
• Medical Imaging Analysis

Background:

• Pulmonary fibrosis extent in systemic sclerosis (SSc) is a key prognostic indicator.
• Chest Computed Tomography (CT) is the standard for diagnosing interstitial lung disease (ILD).
• Current ILD assessment methods (semi-quantitative scores) suffer from observer variability, while quantitative methods use complex software.

Purpose of the Study:

• To evaluate if open-source DICOM viewer software (OsiriX) can generate CT indexes.
• To determine if these CT indexes correlate with established semi-quantitative ILD assessment scores.
• To explore OsiriX's utility in discriminating between limited and extensive ILD in SSc patients.

Main Methods:

• Sixty-three chest CT scans from ILD-SSc patients were analyzed.
• Two semi-quantitative ILD assessment methods (visual extent, limited/extensive grading) were applied.
• CT scans were processed using OsiriX to obtain lung attenuation distribution parameters (kurtosis, skewness, mean).
• Statistical analysis (Spearman rank, Mann-Whitney tests) compared semi-quantitative scores and CT indexes.

Main Results:

• All CT indexes derived from OsiriX showed a statistically significant, moderate correlation with visual extent semi-quantitative assessment (p<0.05).
• Skewness demonstrated the strongest correlation (r=-0.378, p=0.0023).
• CT indexes significantly differed between patients with extensive and limited ILD (p<0.01).

Conclusions:

• CT indexes correlating with radiological semi-quantitative ILD assessment can be reliably obtained using the open-source software OsiriX.
• OsiriX-derived CT indexes offer a valuable, potentially more accessible tool for discriminating between extensive and limited ILD in SSc patients.
• This approach may help overcome the limitations of traditional ILD assessment methods.