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Area of Science:

  • Pulmonology
  • Radiology
  • Medical Classification

Background:

  • Sarcoidosis is a complex disease lacking a unified classification framework.
  • Existing frameworks do not adequately address pathogenetic pathways, genetic factors, or treatment variations.
  • A need exists for standardized diagnostic and outcome measures in sarcoidosis research.

Purpose of the Study:

  • To establish international consensus on high-resolution CT (HRCT) phenotypic separations in sarcoidosis.
  • To provide a foundation for future CT-based research and classification of sarcoidosis.
  • To anchor the development of diagnostic algorithms and outcome measures for sarcoidosis.

Main Methods:

  • A multinational, two-round Delphi consensus process was employed.
  • Participants included members of the Fleischner Society and the World Association of Sarcoidosis and other Granulomatous Disorders.
  • 146 experts (chest physicians and thoracic radiologists) from 28 countries participated.

Main Results:

  • Consensus was achieved on 22 out of 35 statements (63%).
  • 97% agreement was reached on the existence of distinct HRCT phenotypes in sarcoidosis.
  • Seven HRCT phenotypes were identified and categorized as non-fibrotic or likely fibrotic.

Conclusions:

  • The international consensus supports the formulation of a CT classification for sarcoidosis.
  • This classification may serve as a basis for defining distinct sarcoidosis entities.
  • Further refinement of HRCT phenotypes is necessary for a formal sarcoidosis classification.