High-resolution CT phenotypes in pulmonary sarcoidosis: a multinational Delphi consensus study

Desai, Sujal R; Sivarasan, Nishanth; Johannson, Kerri A; George, Peter M; Culver, Daniel A; Devaraj, Anand; Lynch, David A.; Milne, David; Renzoni, Elisabetta; Nunes, Hilario; Sverzellati, Nicola; Spagnolo, Paolo; Baughman, Robert P; Yadav, Ruchi; Piciucchi, Sara; Walsh, Simon L F; Kouranos, Vasileios; Wells, Athol U; Anderson, Adam; Morgenthau, Adam; Gaser, Adrian; Vizel, Alexander; Speranskaya, Alexandra; Gerke, Alicia; Goksel, Altinisik; Undurraga, Alvaro; Sharma, Amita; Oh, Andrea; Leung, Ann; Larici, Anna Rita; Prasse, Antje; Mazzei, Antonietta; Morais, Antonio; Bhalla, Ashu; Del Rio, Belen; Jankharia, Bhavin; Elicker, Brett; Pereira, Carlos; Biegelman-Aubry, Catherine; White, Charles; Ravaglia, Claudia; Hsia, Connie; Schaefer-Prokop, Cornelia; Launay, David; Talwar, Deepak; Castillo, Diego; Patel, Divya; Israel-Biet, Dominique; Valeyre, Dominique; Britt, Edward James; Bargagli, Elena; Bendstrup, Elisabeth; Crouser, Elliott; Nossent, Esther; Shmelev, Eugeny; Porquera, Eva Carmona;...

Abstract

One view of sarcoidosis is that the term covers many different diseases. However, no classification framework exists for the future exploration of pathogenetic pathways, genetic or trigger predilections, patterns of lung function impairment, or treatment separations, or for the development of diagnostic algorithms or relevant outcome measures. We aimed to establish agreement on high-resolution CT (HRCT) phenotypic separations in sarcoidosis to anchor future CT research through a multinational two-round Delphi consensus process. Delphi participants included members of the Fleischner Society and the World Association of Sarcoidosis and other Granulomatous Disorders, as well as members' nominees. 146 individuals (98 chest physicians, 48 thoracic radiologists) from 28 countries took part, 144 of whom completed both Delphi rounds. After rating of 35 Delphi statements on a five-point Likert scale, consensus was achieved for 22 (63%) statements. There was 97% agreement on the existence of distinct HRCT phenotypes, with seven HRCT phenotypes that were categorised by participants as non-fibrotic or likely to be fibrotic. The international consensus reached in this Delphi exercise justifies the formulation of a CT classification as a basis for the possible definition of separate diseases. Further refinement of phenotypes with rapidly achievable CT studies is now needed to underpin the development of a formal classification of sarcoidosis.

Citation

Desai, S. R., Sivarasan, N., Johannson, K. A., George, P. M., Culver, D. A., Devaraj, A., Lynch, D. A., Milne, D., Renzoni, E., Nunes, H., Sverzellati, N., Spagnolo, P., Baughman, R. P., Yadav, R., Piciucchi, S., Walsh, S. L. F., Kouranos, V., Wells, A. U., Anderson, A., Morgenthau, A., …Inoue, Y. (in press). High-resolution CT phenotypes in pulmonary sarcoidosis: a multinational Delphi consensus study. The lancet. Respiratory medicine, https://doi.org/10.1016/S2213-2600%2823%2900267-9

• Journal Article Type: Article
• Acceptance Date: Dec 1, 2023
• Online Publication Date: Dec 14, 2023
• Deposit Date: Dec 15, 2023
• Publicly Available Date: Dec 19, 2023
• Journal: The Lancet Respiratory Medicine
• Print ISSN: 2213-2600
• Electronic ISSN: 2213-2619
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/S2213-2600%2823%2900267-9
• Keywords: Pulmonary and Respiratory Medicine
• Public URL: https://hull-repository.worktribe.com/output/4483890