Photon-counting CT Scan vs Standard HRCT Scan in the Identification of Idiopathic Pulmonary Fibrosis (CT-IPF ANTHEM)
Aperçu de l'étude
Statut
Les conditions
- Fibrose pulmonaire idiopatique
- Maladie pulmonaire interstitielle (MPI)
- Fibrose pulmonaire idiopathique (FPI)
- Maladies pulmonaires interstitielles
- FPI
- Tomodensitométrie
- TDM
- ILD
- Comptage de photons CT
- Maladie pulmonaire interstitielle due à une maladie systémique (trouble de la biologie des télomères)
Intervention / Traitement
Description détaillée
The advent of a new generation of CT systems based on photon-counting detector technology is raising great interest in the medical community, anticipating a major improvement in numerous clinical applications including chest disorders. These expectations are drawn from the technological advantages inherent to these new CT systems, including a higher contrast-to-noise ratio, higher spatial resolution, and lower radiation dose together with the potential of multienergy imaging.
Non-contrast enhanced CT will be acquired in spectral ultra-high-resolution mode on a clinical dual-source photon-counting detector CT (PCDCT) (NAEOTOM Alpha, Siemens Healthineers AG, Forchheim, Germany). All scans will be acquired with automated exposure control.
Recent evidence showed that images obtained with PCDCT allowed a more precise depiction of CT features of ILDs with similar radiation dose. Subjective visualization of specific IPF features, such as reticulation and traction bronchiectasis, using PCDCT has been rated superior to conventional HRCT. Thus, a more precise delineation of fine fibrotic abnormalities could modify the categorization of ILD patterns and improve the diagnostic confidence of IPF and not-IPF diagnosis, reducing the prevalence of unclassifiable ILD.
Type d'étude
Inscription (Estimé)
Contacts et emplacements
Coordonnées de l'étude
- Nom: Francesco Amati, MD
- Numéro de téléphone: +393282592750
- E-mail: franesco.amati@hunimed.eu
Sauvegarde des contacts de l'étude
- Nom: Lisa Usuelli, MD
- Numéro de téléphone: +393400095239
- E-mail: lisa.usuelli@humanitas.it
Lieux d'étude
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Italy
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Rozzano, Italy, Italie, 20089
- Recrutement
- Humanitas Research Hospital
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Contact:
- Lisa Usuelli, MD
- Numéro de téléphone: +393400095239
- E-mail: lisa.usuelli@humanitas.it
-
Contact:
- Francesco Amati, MD
- Numéro de téléphone: +393282592750
- E-mail: francesco.amati@hunimed.eu
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Méthode d'échantillonnage
Population étudiée
Adults patients with a new diagnosis of ILD referred to the outpatient clinic of ILD of Humanitas Research Hospital, Rozzano - Milano) and with the need of a MDD discussion to reach a diagnosis will be enrolled.
MDD will be leaded by two pulmonologists with 5 years of experience in ILDs. Each MDD session will include at least one additional pulmonologist, two thoracic radiologists, one thoracic surgeon, one thoracic pathologist, one rheumatologist, and at least two fellows in respiratory medicine. MDD meetings will be held every week and lasted approximately 60 minutes.
Patients will be discussed using a standard case report form. Two diagnosis will be collected: the first diagnosis will be collected using the HRCT scan imaging. The second diagnosis will be collected using the PCDCT scan imaging.
La description
Inclusion Criteria:
- ≥ 18 years of age
- Any gender
- Any race
- Signed informed consent
- ILD diagnosis with the need for a multidisciplinary discussion
Exclusion Criteria:
- Patients with acute exacerbation of ILD
- Interstitial abnormalities that could be explained by causes different than ILD (e.g.: heart failure; viral)
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
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ILD patients undergoing radiological evaluation
Eligible partecipants will be adults (≥ 18 years of age) with a new diagnosis of ILD referred to the outpatient clinic of ILD of Humanitas Research Hospital, Rozzano - Milano) and with the need of a MDD discussion to reach a diagnosis.
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Non-contrast enhanced CT will be acquired in spectral ultra-high-resolution mode on a clinical dual-source photon-counting detector CT (PCDCT) (NAEOTOM Alpha, Siemens Healthineers AG, Forchheim, Germany).
All scans will be acquired with automated exposure control.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
|---|---|
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Reduction of unclassifiable ILD diagnosis after MDD comparing PCDCT vs standard Chest HRCT scan using McNemar test
Délai: 2 years
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2 years
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Mesures de résultats secondaires
Mesure des résultats |
Délai |
|---|---|
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Increase in IPF diagnosis after MDD comparing PCDCT vs standard Chest HRCT scan using McNemar test
Délai: 2 years
|
2 years
|
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Interobserver agreement among radiologists using Cohen's kappa
Délai: 2 years
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2 years
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Francesco Amati, MD, Humanitas Research Hospital IRCCS, Rozzano-Milan
Publications et liens utiles
Publications générales
- Lynch DA, Sverzellati N, Travis WD, Brown KK, Colby TV, Galvin JR, Goldin JG, Hansell DM, Inoue Y, Johkoh T, Nicholson AG, Knight SL, Raoof S, Richeldi L, Ryerson CJ, Ryu JH, Wells AU. Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society White Paper. Lancet Respir Med. 2018 Feb;6(2):138-153. doi: 10.1016/S2213-2600(17)30433-2. Epub 2017 Nov 15.
- Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, Kreuter M, Lynch DA, Maher TM, Martinez FJ, Molina-Molina M, Myers JL, Nicholson AG, Ryerson CJ, Strek ME, Troy LK, Wijsenbeek M, Mammen MJ, Hossain T, Bissell BD, Herman DD, Hon SM, Kheir F, Khor YH, Macrea M, Antoniou KM, Bouros D, Buendia-Roldan I, Caro F, Crestani B, Ho L, Morisset J, Olson AL, Podolanczuk A, Poletti V, Selman M, Ewing T, Jones S, Knight SL, Ghazipura M, Wilson KC. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2022 May 1;205(9):e18-e47. doi: 10.1164/rccm.202202-0399ST.
- Ryerson CJ, Urbania TH, Richeldi L, Mooney JJ, Lee JS, Jones KD, Elicker BM, Koth LL, King TE Jr, Wolters PJ, Collard HR. Prevalence and prognosis of unclassifiable interstitial lung disease. Eur Respir J. 2013 Sep;42(3):750-7. doi: 10.1183/09031936.00131912. Epub 2012 Dec 6.
- Rajendran K, Koo CW. Photon-counting detector CT: improving interstitial lung disease classification using ultra-high resolution at a fraction of the radiation dose? Eur Radiol. 2023 Aug;33(8):5526-5527. doi: 10.1007/s00330-023-09617-w. Epub 2023 Apr 18. No abstract available.
- Prayer F, Kienast P, Strassl A, Moser PT, Bernitzky D, Milacek C, Gyongyosi M, Kifjak D, Rohrich S, Beer L, Watzenbock ML, Milos RI, Wassipaul C, Gompelmann D, Herold CJ, Prosch H, Heidinger BH. Detection of Post-COVID-19 Lung Abnormalities: Photon-counting CT versus Same-Day Energy-integrating Detector CT. Radiology. 2023 Apr;307(1):e222087. doi: 10.1148/radiol.222087. Epub 2022 Nov 29.
- Hambly N, Farooqi MM, Dvorkin-Gheva A, Donohoe K, Garlick K, Scallan C, Chong SG, MacIsaac S, Assayag D, Johannson KA, Fell CD, Marcoux V, Manganas H, Morisset J, Comes A, Fisher JH, Shapera S, Gershon AS, To T, Wong AW, Sadatsafavi M, Wilcox PG, Halayko AJ, Khalil N, Cox G, Richeldi L, Ryerson CJ, Kolb M. Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry. Eur Respir J. 2022 Oct 6;60(4):2102571. doi: 10.1183/13993003.02571-2021. Print 2022 Oct.
- Guler SA, Ryerson CJ. Unclassifiable interstitial lung disease: from phenotyping to possible treatments. Curr Opin Pulm Med. 2018 Sep;24(5):461-468. doi: 10.1097/MCP.0000000000000509.
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Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 599/24
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