Shear wave elastography-derived scoring system: application in the detection, subdivision and evaluation of systemic...

Area of Science:

• Rheumatology
• Medical Imaging
• Biophysics

Background:

• Systemic sclerosis (SSc) is a complex autoimmune disease characterized by skin thickening.
• Accurate assessment of SSc extent and type is crucial for patient management.
• Current diagnostic and monitoring tools have limitations in quantifying skin involvement.

Purpose of the Study:

• To identify optimal body sites for shear wave elastography (SWE) assessment in SSc.
• To develop and validate a clinically applicable SWE-based scoring system for SSc detection and classification.
• To correlate SWE findings with the modified Rodnan total skin score (mRTSS).

Main Methods:

• Cross-sectional study including patients with limited cutaneous SSc (lcSSc), diffuse cutaneous SSc (dcSSc), and other rheumatic diseases (ORD).
• Skin stiffness was measured using palpation and SWE at multiple body sites.
• Logistic regression analysis was employed to determine the most valuable sites for the scoring system development.

Main Results:

• The developed SWE scoring system demonstrated 80.0% sensitivity and 94.4% specificity for SSc diagnosis.
• The system could differentiate dcSSc from lcSSc with 72.5% sensitivity and 98.0% specificity.
• SWE-derived scores showed a strong positive correlation with mRTSS (r=0.757, p<0.001).

Conclusions:

• The SWE-derived scoring system offers a valuable, non-invasive method for SSc detection and evaluation.
• This scoring system has potential for widespread clinical application in managing SSc patients.
• SWE elastography provides objective data that complements existing clinical assessments of SSc severity.