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Screening for interstitial lung disease in systemic sclerosis: the diagnostic accuracy of HRCT image series with high increment and reduced number of slices
  1. Anna Winklehner1,
  2. Nicole Berger1,
  3. Britta Maurer2,
  4. Oliver Distler2,
  5. Hatem Alkadhi1,
  6. Thomas Frauenfelder1
  1. 1Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
  2. 2Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
  1. Correspondence to Dr Oliver Distler, Department of Rheumatology, University Hospital Zurich, Gloriastrasse 25, CH-8091 Zurich, Switzerland; Oliver.Distler{at}


Objectives The objective of this study is to assess diagnostic accuracy for the detection of interstitial lung disease (ILD) in image series with high increment and reduced number of slices in patients with systemic sclerosis (SSc).

Methods 45 patients with SSc underwent high-resolution CT (HRCT). Three series of secondary captures were reconstructed as follows: series 1, series with 10 mm increment and 1 mm slices; series 2, seven axial images with baso-apical gradient; series 3, three axial images were obtained at the apical, at the level of the carina and basal. The presence and extent of ILD, and the degree of diagnostic confidence were recorded. The effective dose for each image series was estimated. Standard HRCT was the standard of reference.

Results The prevalence of ILD was 55% (25/45). Diagnostic sensitivity and accuracy of series 1, series 2 and series 3 were 100% and 94.4%, 94% and 97.8%, 92% and 97.8%, respectively. The extent of ILD was underestimated in series 3 (p<0.05) and was comparable to the standard HRCT in series 1 and 2 (p>0.05). Estimated dose reduction was more than 90% in all image series.

Conclusions HRCT image series with low sampling rate allow an accurate detection of ILD with very-low-radiation dose, making this approach potentially valuable for screening in patients with SSc.

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  • Competing interests None.

  • Patient consent All patients signed informed consent.

  • Ethics approval Ethical approval was obtained from the institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.