{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:15:28Z","timestamp":1783401328415,"version":"3.54.6"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Roma La Sapienza"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the diagnostic accuracy of two lung ultrasound (LUS) scores (\u2265\u200910 B-lines and pleural line abnormalities according to Fairchild's criteria) for detecting interstitial lung disease (ILD) in systemic sclerosis (SSc), when applied independently at two referral centers using a shared standardized protocol. Secondary aims included evaluating the diagnostic performance of their combined use and their association with ILD severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional bi-center study included same-day LUS and high-resolution computed tomography (HRCT), using a 14-zone scanning protocol. ILD was defined as\u2009\u2265\u200910% lung involvement on HRCT. The diagnostic performance of each LUS score and their combination was assessed using\n                      <jats:italic>OR<\/jats:italic>\n                      and\n                      <jats:italic>AND<\/jats:italic>\n                      rules (the\n                      <jats:italic>OR<\/jats:italic>\n                      rule indicating positivity for either criterion, and the\n                      <jats:italic>AND<\/jats:italic>\n                      rule requiring both to be positive). Associations with disease severity, based on the Goh classification, were also explored.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ILD was present in 68% of the 108 patients included. The\u2009\u2265\u200910 B-lines cut-off showed 90.5% sensitivity and 84.4% specificity (AUC 0.875), while Fairchild's criteria achieved 93.2% sensitivity and 93.8% specificity (AUC 0.935). The OR rule yielded the highest sensitivity (95.9%) and NPV (89.7%), while the AND rule provided the highest specificity (96.9%) and PPV (98.5%). All patients with extensive ILD were positive for both scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real-life multicenter setting, both LUS scores showed high and complementary diagnostic performance when applied within a standardized protocol. Their consistent association with ILD extent supports their clinical use as non-invasive tools for routine SSc-ILD assessment.<\/jats:p>\n                    <jats:p>\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td align=\"left\" colspan=\"2\">\n                                <jats:bold>Key Points<\/jats:bold>\n                                \u2022\n                                <jats:italic>Lung ultrasound shows high diagnostic accuracy for SSc-ILD across two international referral centres.<\/jats:italic>\n                                \u2022\n                                <jats:italic>A standardized 14-zone protocol supports reproducible LUS performance.<\/jats:italic>\n                                \u2022 \u2009\n                                <jats:italic>\u2265\u2009 10 B-lines and Fairchild\u2019s criteria provide complementary diagnostic information.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Combining B-lines and pleural line criteria improves overall diagnostic performance.<\/jats:italic>\n                              <\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-026-08191-y","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:20:45Z","timestamp":1780582845000},"page":"4345-4353","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance of lung ultrasound for systemic sclerosis-associated interstitial lung disease: an international cross-sectional study from two tertiary care centers"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7805-6635","authenticated-orcid":false,"given":"Davide","family":"Mohammad Reza Beigi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Loarce-Martos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Pellegrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Landini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Panebianco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"de la Puente Bujidos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Garc\u00eda de Vicente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Bisconti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Romana","family":"Di Ciommo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Cadar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Arechavala Hita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Truglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Bachiller-Corral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Conti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Riccieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"8191_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-019-0980-7","volume":"20","author":"V Cottin","year":"2019","unstructured":"Cottin V, Brown KK (2019) Interstitial lung disease associated with Systemic Sclerosis (SSc-ILD). Respir Res 20:13","journal-title":"Respir Res"},{"key":"8191_CR2","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1136\/ard.2009.114264","volume":"69","author":"AJ Tyndall","year":"2010","unstructured":"Tyndall AJ et al (2010) Causes and risk factors for death in systemic sclerosis: a study from the EULAR scleroderma trials and research (EUSTAR) database. Ann Rheum Dis 69:1809\u20131815","journal-title":"Ann Rheum Dis"},{"key":"8191_CR3","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.807982","volume":"8","author":"N Landini","year":"2021","unstructured":"Landini N et al (2021) Computed tomography predictors of mortality or disease progression in Systemic Sclerosis-interstitial lung disease: a systematic review. Front Med 8:807982","journal-title":"Front Med"},{"key":"8191_CR4","doi-asserted-by":"publisher","first-page":"166","DOI":"10.2478\/rir-2024-0023","volume":"5","author":"RE Ledda","year":"2024","unstructured":"Ledda RE, Campochiaro C (2024) High resolution computed tomography in systemic sclerosis: From diagnosis to follow-up. Rheumatol Immunol Res 5:166\u2013174","journal-title":"Rheumatol Immunol Res"},{"key":"8191_CR5","doi-asserted-by":"publisher","first-page":"E71","DOI":"10.1016\/S2665-9913(19)30144-4","volume":"2","author":"A-M Hoffmann-Vold","year":"2020","unstructured":"Hoffmann-Vold A-M et al (2020) The identification and management of interstitial lung disease in systemic sclerosis: evidence-based European consensus statements. Lancet Rheumatol 2:E71\u2013E83","journal-title":"Lancet Rheumatol"},{"key":"8191_CR6","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1136\/annrheumdis-2020-217455","volume":"80","author":"A-M Hoffmann-Vold","year":"2021","unstructured":"Hoffmann-Vold A-M et al (2021) Progressive interstitial lung disease in patients with Systemic Sclerosis-associated interstitial lung disease in the EUSTAR database. Ann Rheum Dis 80:219\u2013227","journal-title":"Ann Rheum Dis"},{"key":"8191_CR7","doi-asserted-by":"publisher","first-page":"3547","DOI":"10.1007\/s10067-021-05761-0","volume":"40","author":"EF Vicente-Rabaneda","year":"2021","unstructured":"Vicente-Rabaneda EF, Bong DA, Casta\u00f1eda S, M\u00f6ller I (2021) Use of ultrasound to diagnose and monitor interstitial lung disease in rheumatic diseases. Clin Rheumatol 40:3547\u20133564","journal-title":"Clin Rheumatol"},{"key":"8191_CR8","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1080\/1744666X.2023.2198212","volume":"19","author":"A Makol","year":"2023","unstructured":"Makol A et al (2023) Recent innovations in the screening and diagnosis of Systemic Sclerosis-associated interstitial lung disease. Expert Rev Clin Immunol 19:613\u2013626","journal-title":"Expert Rev Clin Immunol"},{"key":"8191_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2024.152406","volume":"65","author":"A DelleSedie","year":"2024","unstructured":"DelleSedie A et al (2024) Standardization of interstitial lung disease assessment by ultrasound: results from a Delphi process and web-reliability exercise by the OMERACT ultrasound working group. Semin Arthritis Rheum 65:152406","journal-title":"Semin Arthritis Rheum"},{"key":"8191_CR10","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13081429","volume":"13","author":"M Radi\u0107","year":"2023","unstructured":"Radi\u0107 M et al (2023) Pulmonary ultrasonography in systemic sclerosis-induced interstitial lung disease-a systematic review and meta-analysis. Diagnostics 13:1429","journal-title":"Diagnostics"},{"key":"8191_CR11","first-page":"279","volume":"42","author":"A Smargiassi","year":"2023","unstructured":"Smargiassi A et al (2023) Vertical artifacts as lung ultrasound signs: trick or trap? Part 2- an accademia di ecografia toracica position paper on b-lines and sonographic interstitial syndrome. J Ultrasound Med Off J Am Inst Ultrasound Med 42:279\u2013292","journal-title":"J Ultrasound Med Off J Am Inst Ultrasound Med"},{"key":"8191_CR12","first-page":"S136","volume":"33","author":"I Pinal-Fernandez","year":"2015","unstructured":"Pinal-Fernandez I et al (2015) Pleural irregularity, a new ultrasound sign for the study of interstitial lung disease in systemic sclerosis and antisynthetase syndrome. Clin Exp Rheumatol 33:S136-141","journal-title":"Clin Exp Rheumatol"},{"key":"8191_CR13","doi-asserted-by":"publisher","first-page":"389","DOI":"10.3109\/03009742.2015.1011228","volume":"44","author":"M Sperandeo","year":"2015","unstructured":"Sperandeo M et al (2015) Ultrasound signs of pulmonary fibrosis in systemic sclerosis as timely indicators for chest computed tomography. Scand J Rheumatol 44:389\u2013398","journal-title":"Scand J Rheumatol"},{"key":"8191_CR14","first-page":"488","volume":"15","author":"C Rotondo","year":"2025","unstructured":"Rotondo C et al (2025) Transthoracic lung ultrasound in systemic sclerosis-associated interstitial lung disease: capacity to differentiate chest computed-tomographic characteristic patterns. Diagn Basel Switz 15:488","journal-title":"Diagn Basel Switz"},{"key":"8191_CR15","doi-asserted-by":"publisher","first-page":"R134","DOI":"10.1186\/ar3446","volume":"13","author":"M Gutierrez","year":"2011","unstructured":"Gutierrez M et al (2011) Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders\u2013preliminary results. Arthritis Res Ther 13:R134","journal-title":"Arthritis Res Ther"},{"key":"8191_CR16","doi-asserted-by":"publisher","first-page":"e0566","DOI":"10.1097\/MD.0000000000010566","volume":"97","author":"M Tardella","year":"2018","unstructured":"Tardella M et al (2018) Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis: Cut-off point definition for the presence of significant pulmonary fibrosis. Medicine (Baltimore) 97:e0566","journal-title":"Medicine (Baltimore)"},{"key":"8191_CR17","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1002\/acr.24338","volume":"73","author":"R Fairchild","year":"2021","unstructured":"Fairchild R et al (2021) Development and assessment of novel lung ultrasound interpretation criteria for the detection of interstitial lung disease in systemic sclerosis. Arthritis Care Res 73:1338\u20131342","journal-title":"Arthritis Care Res"},{"key":"8191_CR18","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25567","author":"RM Fairchild","year":"2025","unstructured":"Fairchild RM et al (2025) Validation of lung ultrasound interpretation criteria for interstitial lung disease in systemic sclerosis and inflammatory myopathy. Arthritis Care Res. https:\/\/doi.org\/10.1002\/acr.25567","journal-title":"Arthritis Care Res"},{"key":"8191_CR19","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead324","author":"D Mohammad Reza Beigi","year":"2023","unstructured":"Mohammad Reza Beigi D et al (2023) Lung ultrasound compared to computed tomography detection and automated quantification of systemic sclerosis-associated interstitial lung disease: preliminary study. Rheumatology (Oxford). https:\/\/doi.org\/10.1093\/rheumatology\/kead324","journal-title":"Rheumatology (Oxford)"},{"key":"8191_CR20","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaf328","author":"D Mohammad Reza Beigi","year":"2025","unstructured":"Mohammad Reza Beigi D et al (2025) Comparison of quantitative lung ultrasound scores with automated quantitative CT: to overcome the ultrasound limitations. Rheumatology (Oxford). https:\/\/doi.org\/10.1093\/rheumatology\/keaf328","journal-title":"Rheumatology (Oxford)"},{"key":"8191_CR21","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1002\/art.38098","volume":"65","author":"F van den Hoogen","year":"2013","unstructured":"van den Hoogen F et al (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology\/European League against Rheumatism collaborative initiative. Arthritis Rheum 65:2737\u20132747","journal-title":"Arthritis Rheum"},{"key":"8191_CR22","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1148\/rg.321105058","volume":"32","author":"J Capobianco","year":"2012","unstructured":"Capobianco J et al (2012) Thoracic manifestations of collagen vascular diseases. Radiographics 32:33\u201350","journal-title":"Radiographics"},{"key":"8191_CR23","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1164\/rccm.200706-877OC","volume":"177","author":"NSL Goh","year":"2008","unstructured":"Goh NSL et al (2008) Interstitial lung disease in systemic sclerosis: a simple staging system. Am J Respir Crit Care Med 177:1248\u20131254","journal-title":"Am J Respir Crit Care Med"},{"key":"8191_CR24","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1126\/science.3287615","volume":"240","author":"JA Swets","year":"1988","unstructured":"Swets JA (1988) Measuring the accuracy of diagnostic systems. Science 240:1285\u20131293","journal-title":"Science"},{"key":"8191_CR25","doi-asserted-by":"publisher","first-page":"SI56","DOI":"10.1093\/rheumatology\/keab801","volume":"61","author":"L Gargani","year":"2022","unstructured":"Gargani L et al (2022) Lung ultrasound B-lines in systemic sclerosis: cut-off values and methodological indications for interstitial lung disease screening. Rheumatology (Oxford) 61:SI56\u2013SI64","journal-title":"Rheumatology (Oxford)"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08191-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-026-08191-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08191-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:27:42Z","timestamp":1783398462000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10067-026-08191-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["8191"],"URL":"https:\/\/doi.org\/10.1007\/s10067-026-08191-y","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"assertion":[{"value":"23 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the local Ethics Committees of the participating centers (Rome: ref. No. 7282; Madrid: ref. No. 328\/22). Written informed consent was obtained from all participants prior to enrolment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}