High resolution computed tomography in systemic sclerosis: From diagnosis to follow-up

Area of Science:

• Radiology
• Pulmonology
• Rheumatology

Background:

• Early diagnosis of interstitial lung disease (ILD) and pulmonary hypertension (PH) is critical for managing systemic sclerosis (SSc).
• Diagnosing SSc-ILD presents challenges due to non-specific early symptoms.
• High-resolution computed tomography (HRCT) is the gold standard for evaluating SSc-ILD.

Purpose of the Study:

• To discuss the primary chest computed tomography (CT) findings in systemic sclerosis (SSc).
• To emphasize the role of HRCT in baseline and follow-up assessments of SSc-ILD.
• To highlight imaging's importance in monitoring disease progression and treatment response.

Main Methods:

• Review of chest CT manifestations in systemic sclerosis.
• Focus on HRCT findings for SSc-ILD.
• Discussion of imaging's role in baseline and serial evaluations.

Main Results:

• HRCT is the most accurate imaging modality for SSc-ILD.
• Common HRCT patterns include non-specific interstitial pneumonia (NSIP) with ground-glass opacities and traction bronchiectasis.
• Less frequent patterns include usual interstitial pneumonia (UIP), diffuse alveolar damage (DAD), diffuse alveolar hemorrhage (DAH), and organizing pneumonia (OP).

Conclusions:

• HRCT is essential for diagnosing and monitoring SSc-ILD.
• The extent of disease on HRCT correlates with prognosis.
• Serial HRCT assessments aid in tracking disease progression and treatment efficacy.