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Lung Elastance and Microvascularization as Quantitative Non-Invasive Biomarkers for the Aetiological Diagnosis of
Sergi Huerta-Calpe1,2,3, Carmina Guitart1,2, Josep Lluis Carrasco4
1Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona (UB), Passeig Sant Joan de Déu, 2, 08950 Barcelona, Spain.
Insights
New lung ultrasound biomarkers can help differentiate bacterial pneumonia from atelectasis in children, potentially reducing invasive tests and improving treatment for acute lower respiratory tract conditions.
Area of Science:
- Pediatric Pulmonology
- Medical Imaging
- Diagnostic Biomarkers
Background:
- Acute lower respiratory tract conditions are common in children, often presenting as lung consolidations.
- Bacterial pneumonia (BP) is a frequent cause, necessitating accurate diagnosis for effective treatment.
- Current diagnostic methods like chest X-ray and blood tests can be invasive; lung ultrasound (LUS) offers a less invasive alternative, though differentiating causes like atelectasis remains challenging.
Purpose of the Study:
- To evaluate the diagnostic accuracy of novel, non-invasive imaging biomarkers (lung elastance and microvascularization ratio) for distinguishing bacterial pneumonia from atelectasis.
- To establish reference values for these biomarkers in healthy lung tissue.
- To compare biomarker values between patients with bacterial pneumonia and atelectasis.
Main Methods:
- Prospective cohort study conducted at Sant Joan de Déu Hospital, Spain (June 2025-June 2027).
- Measurement of lung elastance and microvascularization ratio in healthy lung tissue using a standardized LUS protocol.
- Assessment of these biomarkers in pediatric patients with confirmed lung consolidation via LUS, categorized into bacterial pneumonia and atelectasis groups.
Main Results:
- The study will determine statistically significant differences in biomarker values compared to normal lung tissue.
- It aims to identify significant differences in biomarker values between the bacterial pneumonia and atelectasis groups.
- The primary outcome is the diagnostic accuracy of the proposed biomarkers.
Conclusions:
- Validated non-invasive biomarkers could significantly decrease the reliance on invasive diagnostic procedures.
- Improved diagnostic accuracy for lung consolidation in pediatric patients can lead to better therapeutic management.
- This research has the potential to enhance the clinical approach to bacterial pneumonia and other pulmonary conditions presenting with consolidation.
Abstract:
Background: Acute lower respiratory tract conditions are highly prevalent in paediatrics. Many of these conditions present as consolidations on imaging studies. One of the most common causes is bacterial pneumonia (BP), which requires an accurate diagnosis to implement the best treatment plan. Despite the fact that major guidelines constrain the use of invasive tests, chest X-ray (CXR) or blood tests are still routinely used for the diagnosis. In this regard, the introduction of lung ultrasound (LUS) signified an advancement in reducing the invasiveness of diagnosis. However, there are still situations where distinguishing between different aetiologies remains challenging, especially in the case of atelectasis. Methods: This is a prospective cohort study to assess the diagnostic accuracy of new non-invasive, quantifiable, and reproducible imaging biomarkers (lung elastance and microvascularization ratio) for differentiating BP from another major entity that causes the appearance of consolidation in imaging tests, atelectasis. It will be conducted at Sant Joan de Déu Hospital in Spain from June 2025 to June 2027. Firstly, imaging biomarkers will be measured in well-aerated lung tissue without consolidation to establish their values in healthy lung tissue, according to a predefined imaging acquisition protocol. Subsequently, the imaging biomarkers will be assessed in patients with confirmed lung consolidation by LUS (Group 1: BP; Group 2: atelectasis). Results: The study aims to determine whether there are statistically significant differences in the biomarker values in relation to the normal values and between the different etiological groups. Conclusions: The demonstration of the reliable diagnostic accuracy of these biomarkers could significantly reduce the need for invasive techniques and improve the therapeutic management of many patients with BP and other pulmonary conditions presenting with consolidation in imaging tests.
