Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease
Background. There is no radiological measurement to estimate the severity of pediatrics juvenile dermatomyositis (JDM) with interstitial lung disease (ILD). We validated the effectiveness of CT scoring assessment in JDM patients with ILD. Aim. To establish a CT scoring system and calculate CT scores...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2023-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2023/5607473 |
| _version_ | 1797852968058355712 |
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| author | Chi Wang Jun Hou Jianming Lai Ran Tao Yang Yang Wenhan Hao Xinyu Yuan Yuchun Yan |
| author_facet | Chi Wang Jun Hou Jianming Lai Ran Tao Yang Yang Wenhan Hao Xinyu Yuan Yuchun Yan |
| author_sort | Chi Wang |
| collection | DOAJ |
| description | Background. There is no radiological measurement to estimate the severity of pediatrics juvenile dermatomyositis (JDM) with interstitial lung disease (ILD). We validated the effectiveness of CT scoring assessment in JDM patients with ILD. Aim. To establish a CT scoring system and calculate CT scores in JDM patients with ILD and to determine its reliability and the correlation with Krebs von den Lungen-6 (KL-6). Methods. The study totally enrolled 46 JDM-ILD patients and 16 JDM without ILD (non-ILD, NILD) patients. The chest CT images (7.0 ± 3.6 years; 32 male and 30 female) were all analyzed. CT scores of six lung zones were retrospectively calculated, included image pattern score and distribution range score. Image pattern score was defined as follows: increased broncho-vascular bundle (1 point); ground glass opacity (GGO) (2 points); consolidation (3 points); GGO with bronchiectasis (4 points); consolidation with bronchiectasis (5 points); and honeycomb lung (6 points). Distribution range score was defined as no infiltrate (0 point); <30% (1 point); 30%–60% (2 points); and ≥60% (3 points). Two pediatric radiologists reviewed all CT images independently. The ROC curve was established, and the optimal cutoff score for severity discrimination was set. Results. The agreement between two observers was excellent, and the ICC was 0.930 (95% CI 0.882–0.959, p<0.01). CT score and KL-6 level had a positive linear correlation (r = 0.784, p<0.01). However, the correlation between CT scores of different lung zone and KL-6 level was different. The KL-6 cut off level suggested for JDM with ILD was 209.0 U/ml, with 73.9% sensitivity and 87.5% specificity, and the area under curve was (AUC) 0.864 (p<0.01). Conclusion. The CT scoring system we established, as a semiquantitative method, can effectively evaluate ILD in JDM-PM patients and provide reliable evidence for treatment. |
| first_indexed | 2024-04-09T19:42:58Z |
| format | Article |
| id | doaj.art-2d292c43985f4265ad71f576c1cacad1 |
| institution | Directory Open Access Journal |
| issn | 1916-7245 |
| language | English |
| last_indexed | 2024-04-09T19:42:58Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj.art-2d292c43985f4265ad71f576c1cacad12023-04-04T00:00:16ZengHindawi LimitedCanadian Respiratory Journal1916-72452023-01-01202310.1155/2023/5607473Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung DiseaseChi Wang0Jun Hou1Jianming Lai2Ran Tao3Yang Yang4Wenhan Hao5Xinyu Yuan6Yuchun Yan7Department of RadiologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyBackground. There is no radiological measurement to estimate the severity of pediatrics juvenile dermatomyositis (JDM) with interstitial lung disease (ILD). We validated the effectiveness of CT scoring assessment in JDM patients with ILD. Aim. To establish a CT scoring system and calculate CT scores in JDM patients with ILD and to determine its reliability and the correlation with Krebs von den Lungen-6 (KL-6). Methods. The study totally enrolled 46 JDM-ILD patients and 16 JDM without ILD (non-ILD, NILD) patients. The chest CT images (7.0 ± 3.6 years; 32 male and 30 female) were all analyzed. CT scores of six lung zones were retrospectively calculated, included image pattern score and distribution range score. Image pattern score was defined as follows: increased broncho-vascular bundle (1 point); ground glass opacity (GGO) (2 points); consolidation (3 points); GGO with bronchiectasis (4 points); consolidation with bronchiectasis (5 points); and honeycomb lung (6 points). Distribution range score was defined as no infiltrate (0 point); <30% (1 point); 30%–60% (2 points); and ≥60% (3 points). Two pediatric radiologists reviewed all CT images independently. The ROC curve was established, and the optimal cutoff score for severity discrimination was set. Results. The agreement between two observers was excellent, and the ICC was 0.930 (95% CI 0.882–0.959, p<0.01). CT score and KL-6 level had a positive linear correlation (r = 0.784, p<0.01). However, the correlation between CT scores of different lung zone and KL-6 level was different. The KL-6 cut off level suggested for JDM with ILD was 209.0 U/ml, with 73.9% sensitivity and 87.5% specificity, and the area under curve was (AUC) 0.864 (p<0.01). Conclusion. The CT scoring system we established, as a semiquantitative method, can effectively evaluate ILD in JDM-PM patients and provide reliable evidence for treatment.http://dx.doi.org/10.1155/2023/5607473 |
| spellingShingle | Chi Wang Jun Hou Jianming Lai Ran Tao Yang Yang Wenhan Hao Xinyu Yuan Yuchun Yan Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease Canadian Respiratory Journal |
| title | Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease |
| title_full | Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease |
| title_fullStr | Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease |
| title_full_unstemmed | Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease |
| title_short | Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease |
| title_sort | correlation between ct score and kl 6 a severity assessing in juvenile dermatomyositis associated interstitial lung disease |
| url | http://dx.doi.org/10.1155/2023/5607473 |
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