TY - JOUR
T1 - Standardization of interstitial lung disease assessment by ultrasound
T2 - results from a Delphi process and web-reliability exercise by the OMERACT ultrasound working group
AU - Delle Sedie, Andrea
AU - Terslev, Lene
AU - Bruyn, George A W
AU - Cazenave, Tomas
AU - Chrysidis, Stavros
AU - Diaz, Mario
AU - Di Carlo, Marco
AU - Frigato, Marilena
AU - Gargani, Luna
AU - Gutierrez, Marwin
AU - Hocevar, Alojzija
AU - Iagnocco, Annamaria
AU - Juche, Aaron
AU - Keen, Helen
AU - Mandl, Peter
AU - Naredo, Esperanza
AU - Mortada, Mohamed
AU - Pineda, Carlos
AU - Karalilova, Rositsa
AU - Porta, Francesco
AU - Ravagnani, Viviana
AU - Scirè, Carlo
AU - Serban, Teodora
AU - Smith, Kate
AU - Stoenoiu, Maria S
AU - Tardella, Marika
AU - Torralba, Karina
AU - Wakefield, Richard
AU - D'Agostino, Maria Antonietta
AU - OMERACT US Task Force on Lung US in Rheumatology
N1 - Copyright © 2024. Published by Elsevier Inc.
PY - 2024
Y1 - 2024
N2 - OBJECTIVES: Over the last years ultrasound has shown to be an important tool for evaluating lung involvement, including interstitial lung disease (ILD) a potentially severe systemic involvement in many rheumatic and musculoskeletal diseases (RMD). Despite the potential sensitivity of the technique the actual use is hampered by the lack of consensual definitions of elementary lesions to be assessed and of the scanning protocol to apply. Within the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group we aimed at developing consensus-based definitions for ultrasound detected ILD findings in RMDs and assessing their reliability in dynamic images.METHODS: Based on the results from a systematic literature review, several findings were identified for defining the presence of ILD by ultrasound (i.e., Am-lines, B-lines, pleural cysts and pleural line irregularity). Therefore, a Delphi survey was conducted among 23 experts in sonography to agree on which findings should be included and on their definitions. Subsequently, a web-reliability exercise was performed to test the reliability of the agreed definitions on video-clips, by using kappa statistics.RESULTS: After three rounds of Delphi an agreement >75 % was obtained to include and define B-lines and pleural line irregularity as elementary lesions to assess. The reliability in the web-based exercise, consisting of 80 video-clips (30 for pleural line irregularity, 50 for B-lines), showed moderate inter-reader reliability for both B-lines (kappa = 0.51) and pleural line irregularity (kappa = 0.58), while intra-reader reliability was good for both B-lines (kappa = 0.72) and pleural line irregularity (kappa = 0.75).CONCLUSION: Consensus-based ultrasound definitions for B-lines and pleural line irregularity were obtained, with moderate to good reliability to detect these lesions using video-clips. The next step will be testing the reliability in patients with ILD linked to RMDs and to propose a consensual and standardized protocol to scan such patients.
AB - OBJECTIVES: Over the last years ultrasound has shown to be an important tool for evaluating lung involvement, including interstitial lung disease (ILD) a potentially severe systemic involvement in many rheumatic and musculoskeletal diseases (RMD). Despite the potential sensitivity of the technique the actual use is hampered by the lack of consensual definitions of elementary lesions to be assessed and of the scanning protocol to apply. Within the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group we aimed at developing consensus-based definitions for ultrasound detected ILD findings in RMDs and assessing their reliability in dynamic images.METHODS: Based on the results from a systematic literature review, several findings were identified for defining the presence of ILD by ultrasound (i.e., Am-lines, B-lines, pleural cysts and pleural line irregularity). Therefore, a Delphi survey was conducted among 23 experts in sonography to agree on which findings should be included and on their definitions. Subsequently, a web-reliability exercise was performed to test the reliability of the agreed definitions on video-clips, by using kappa statistics.RESULTS: After three rounds of Delphi an agreement >75 % was obtained to include and define B-lines and pleural line irregularity as elementary lesions to assess. The reliability in the web-based exercise, consisting of 80 video-clips (30 for pleural line irregularity, 50 for B-lines), showed moderate inter-reader reliability for both B-lines (kappa = 0.51) and pleural line irregularity (kappa = 0.58), while intra-reader reliability was good for both B-lines (kappa = 0.72) and pleural line irregularity (kappa = 0.75).CONCLUSION: Consensus-based ultrasound definitions for B-lines and pleural line irregularity were obtained, with moderate to good reliability to detect these lesions using video-clips. The next step will be testing the reliability in patients with ILD linked to RMDs and to propose a consensual and standardized protocol to scan such patients.
UR - http://www.scopus.com/inward/record.url?scp=85185811115&partnerID=8YFLogxK
U2 - 10.1016/j.semarthrit.2024.152406
DO - 10.1016/j.semarthrit.2024.152406
M3 - Journal article
C2 - 38401294
SN - 0049-0172
VL - 65
JO - Seminars in Arthritis and Rheumatism
JF - Seminars in Arthritis and Rheumatism
M1 - 152406
ER -