Thoracic ultrasound combined with low-dose computed tomography may represent useful screening strategy in highly exposed population in the industrial city of Taranto (Italy).

Autor:	Quarato CMI; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Dama E; Cancer Biomarkers Unit, Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Maggi M; Department of Emergency Medicine and Critical Care, Emergency Medicine Unit, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Feragalli B; Department of Medical, Oral and Biotechnological Sciences, Radiology Unit, 'G. D'Annunzio,' University of Chieti-Pescara, Chieti, Italy., Borelli C; Department of Radiology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Del Colle A; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Taurchini M; Unit of Thoracic Surgery, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Maiello E; Unit of Oncology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., De Cosmo S; Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Lacedonia D; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Barbaro MPF; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Carpagnano GE; Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University 'Aldo Moro' of Bari, Bari, Italy., Scioscia G; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Graziano P; Unit of Patology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Termine R; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Frongillo E; Unit of Thoracic Surgery, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Santamaria S; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Venuti M; Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario 'Riuniti' di Foggia, University of Foggia, Foggia, Italy., Grimaldi MA; Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Notarangelo S; Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Saponara A; Unità Sanitaria Locale (ASL) di Potenza, Potenza, Italy., Copetti M; Unit of Biostatistics, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Colangelo T; Cancer Biomarkers Unit, Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Cuttano R; Cancer Biomarkers Unit, Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Macrodimitris D; Internal Medicine, 'San Pio' Hospital, Azienda Sanitaria Locale (ASL) di Castellaneta, Castellaneta, Italy., Mazzarelli F; Cancer Biomarkers Unit, Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Talia M; Internal Medicine, 'Bernardini' Nursing Home, Taranto, Italy., Mirijello A; Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Pazienza L; Department of Radiology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Perna R; Clinical Trial Office-Scientific Direction, IRCCS Fondazione Casa Sollievo della Sofferenza, Foggia, Italy., Simeone A; Department of Radiology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Vergara D; Department of Radiology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Varriale A; Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Carella M; Division of Medical Genetics, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Bianchi F; Cancer Biomarkers Unit, Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy., Sperandeo M; Unit of Interventional and Diagnostic Ultrasound of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2023 May 16; Vol. 10, pp. 1146807. Date of Electronic Publication: 2023 May 16 (Print Publication: 2023).
DOI:	10.3389/fmed.2023.1146807
Abstrakt:	Objectives: We validated a screening protocol in which thoracic ultrasound (TUS) acts as a first-line complementary imaging technique in selecting patients which may deserve a second-line low-dose high resolution computed tomography (HRCT) scan among a population of asymptomatic high-risk subjects for interstitial lung abnormalities (ILA) and lung cancer. Due to heavy environmental pollution burden, the district Tamburi of Taranto has been chosen as "case study" for this purpose. Methods: From July 2018 to October 2020, 677 patients aged between 45 and 65 year and who had been living in the Tamburi district of Taranto for at least 10 years were included in the study. After demographic, clinical and risk factor exposition data were collected, each participant underwent a complete TUS examination. These subjects were then asked to know if they agreed to perform a second-level examination by low-dose HRCT scan. Results: On a total of 167 subjects (24.7%) who agreed to undergo a second-level HRCT, 85 patients (50.9%) actually showed pleuro-pulmonary abnormalities. Interstitial abnormalities were detected in a total of 36 patients on HRCT scan. In particular, 34 participants presented subpleural ILAs, that were classified in the fibrotic subtype in 7 cases. The remaining 2 patients showed non-subpleural interstitial abnormalities. Subpleural nodules were observed in 46 patients. TUS showed an overall diagnostic accuracy of 88.6% in detecting pleuro-pulmonary abnormalities in comparison with HRCT scan, with a sensitivity of 95.3%, a specificity of 81.7%, a positive predictive value of 84.4% and a negative predictive value of 94.4%. The matched evaluation of specific pulmonary abnormalities on HRTC scan (i.e., interstitial abnormalities or pulmonary nodules) with determinate sonographic findings revealed a reduction in both TUS sensibility and specificity. Focusing TUS evaluation on the assessment of interstitial abnormalities, a thickened pleural line showed a sensitivity of 63.9% and a specificity of 69.5%, hypoechoic striae showed a sensitivity of 38.9% and a specificity of 90.1% and subpleural nodules showed a sensitivity of 58.3% and a specificity of 77.1%. Regarding to the assessment of subpleural nodules, TUS showed a sensitivity of 60.9% and a specificity of 81.0%. However, the combined employment of TUS examination and HRCT scans allowed to identify 34 patients with early subpleural ILA and to detect three suspicious pulmonary nodules (of which two were intraparenchymal and one was a large subpleural mass), which revealed to be lung cancers on further investigations. Conclusion: A first-line TUS examination might aid the identification of subjects highly exposed to environmental pollution, who could benefit of a second-line low-dose HRCT scan to find early interstitial lung diseases as well as lung cancer. Protocol Registration Code: PLEURO-SCREENING-V1.0_15 Feb, 17. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Quarato, Dama, Maggi, Feragalli, Borelli, Del Colle, Taurchini, Maiello, De Cosmo, Lacedonia, Barbaro, Carpagnano, Scioscia, Graziano, Termine, Frongillo, Santamaria, Venuti, Grimaldi, Notarangelo, Saponara, Copetti, Colangelo, Cuttano, Macrodimitris, Mazzarelli, Talia, Mirijello, Pazienza, Perna, Simeone, Vergara, Varriale, Carella, Bianchi and Sperandeo.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu