Computed Tomography of the Chest to Screen for Interstitial Lung Disease in Patients With Systemic Sclerosis at Expert Scleroderma Centers in the United States

Authors

Elana J. Bernstein, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.
Shervin Assassi, University of Texas Health Science Center at Houston, Houston, Texas.
Flavia V. Castelino, Massachusetts General Hospital, Boston, Massachusetts.
Lorinda Chung, Stanford University and Palo Alto VA Healthcare System, Palo Alto, California.
Chase Correia, Northwestern University, Chicago, Illinois.
Luke B. Evnin, Scleroderma Research Foundation, San Francisco, California.
Tracy M. Frech, University of Utah, Salt Lake City, and Vanderbilt University Medical Center, Nashville, Tennessee.
Jessica K. Gordon, Hospital for Special Surgery, New York, New York.
Brian A. Skaug, University of Texas Health Science Center at Houston, Houston, Texas.
Faye N. Hant, Medical University of South Carolina, Charleston, South Carolina.
Laura K. Hummers, Johns Hopkins University, Baltimore, Maryland.
Nora Sandorfi, University of Pennsylvania, Philadelphia, Pennsylvania.
Ami A. Shah, Johns Hopkins University, Baltimore, Maryland.
Victoria K. Shanmugam, The George Washington University, Washington, DC.
Virginia D. Steen, Georgetown University, Washington, DC.
Dinesh Khanna, University of Michigan, Ann Arbor, Michigan.

Document Type

Journal Article

Publication Date

4-23-2022

Journal

ACR open rheumatology

DOI

10.1002/acr2.11434

Abstract

OBJECTIVE: Although a high-resolution computed tomography (HRCT) scan of the chest is the gold standard test for the detection of interstitial lung disease (ILD), there is no consensus among rheumatologists regarding the use of HRCT to screen for ILD in their patients with systemic sclerosis (SSc). The aims of this study were to describe the HRCT ordering practices at SSc centers in the United States and to determine which patient characteristics are associated with HRCT performance. METHODS: We performed a prospective cohort study of patients with SSc enrolled in the US-based Collaborative National Quality and Efficacy Registry (CONQUER). We performed univariate logistic regression followed by multivariable logistic regression to determine which patient characteristics were associated with HRCT performance. RESULTS: Of the 356 patients with SSc enrolled in CONQUER, 286 (80.3%) underwent HRCT at some point during their disease course. On multivariable analyses, missing total lung capacity percent predicted (odds ratio [OR] 3.26, 95% confidence interval [CI]: 1.53-7.41, P = 0.007) was positively associated with ever having undergone HRCT, whereas a positive anti-centromere antibody (OR 0.27, 95% CI: 0.12-0.61, P = 0.008) and missing forced vital capacity percent predicted (OR 0.29, 95% CI: 0.10-0.80, P = 0.005) were negatively associated with ever having undergone HRCT. There was a trend toward a positive association between crackles on pulmonary exam and ever having undergone HRCT (OR 2.28, 95% CI: 0.97-6.05, P = 0.058), although this relationship did not reach statistical significance. CONCLUSION: The majority of patients with SSc enrolled in CONQUER underwent HRCT. A positive anti-centromere antibody was the key clinical variable inversely associated with performance of HRCT.

APA Citation

Bernstein, Elana J.; Assassi, Shervin; Castelino, Flavia V.; Chung, Lorinda; Correia, Chase; Evnin, Luke B.; Frech, Tracy M.; Gordon, Jessica K.; Skaug, Brian A.; Hant, Faye N.; Hummers, Laura K.; Sandorfi, Nora; Shah, Ami A.; Shanmugam, Victoria K.; Steen, Virginia D.; and Khanna, Dinesh, "Computed Tomography of the Chest to Screen for Interstitial Lung Disease in Patients With Systemic Sclerosis at Expert Scleroderma Centers in the United States" (2022). GW Authored Works. Paper 753.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/753

Department

Anatomy and Regenerative Biology