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Peer-reviewedCC BYRheumatology advances in practice

Thoracic ultrasound finding interstitial lung disease in SLE: a diagnostic test accuracy study.

  • Henrik Zachar Langkilde1,2
  • Bjørk K Sofíudóttir1
  • Jesper Rømhild Davidsen3,4
  • Stefan Markus Walbom Harders5
  • Stefan Møller Luef3
  • Susan Due Kay1
  • Elisabet Svenungsson6
  • Sille Fløjborg7
  • Robin Christensen1,8
  • Anne Voss1
8 affiliations
  1. 1Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.
  2. 2Department of Rheumatology, Midt og Vestsjællands Sygehus, Slagelse, Denmark.
  3. 3Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.
  4. 4South Danish Center for Interstitial Lung Diseases (SCILS) and Pulmo-Rheuma Frontline Center (PURE), Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.
  5. 5Research Unit of Department of Radiology, University of Southern Denmark, Odense University Hospital, Odense, Denmark.
  6. 6Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
  7. 7Systemic Lupus Erythematosus Patient Research Partner, Department of Rheumatology, Odense University Hospital, Odense, Denmark.
  8. 8Section for Biostatistics and Evidence-Based Research, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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Abstract

Objectives

Interstitial lung diseases (ILDs) are frequent and clinically important in SLE but diagnosis of ILD can be challenging. Thoracic ultrasound (TUS) shows promise in detecting ILD, hence, we aimed to evaluate the utility of TUS to identify ILD in SLE.Methods

Patients fulfilling the EULAR/ACR 2019 SLE classification criteria were invited. Participants were assessed for ILD by means of chest high-resolution computed tomography scans and pulmonary function tests and diagnosed at a multidisciplinary discussion, according to reference standards, independent of TUS. TUS evaluated the presence of B-lines and pleural abnormalities, blinded to status of ILD. The ability of B-lines to identify ILD using a prespecified threshold of ≥10 B-lines was analysed using diagnostic test accuracy measures. Further, we explored the diagnostic performance of B-lines and pleural abnormalities to identify ILD across various scenarios.Results

Among 185 patients with SLE, ILD were present in 22 (12%). With the predefined threshold of ≥10 B-lines, we found a modest diagnostic test accuracy as 14 of 22 ILD cases were classified as abnormal TUS, with diagnostic odds ratio of 10.7 (3.2-32.3), sensitivity of 64% (41-83%) and negative predictive value 97% (90-98%). In exploratory analyses, excluding participants with certain characteristics possibly affecting the TUS from the analyses improved the performance of TUS and pleural abnormalities were associated with ILD.Conclusion

In SLE, TUS focusing on the presence of B-lines demonstrated modest but statistically significant diagnostic test accuracy for detecting ILD. Pleural abnormalities were significantly associated to ILD.

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Cite

BibTeXRIS
BibTeX
@article{langkilde2026thoracic,
  title = {{Thoracic ultrasound finding interstitial lung disease in SLE: a diagnostic test accuracy study.}},
  author = {Henrik Zachar Langkilde and Bjørk K Sofíudóttir and Jesper Rømhild Davidsen and Stefan Markus Walbom Harders and Stefan Møller Luef and Susan Due Kay and Elisabet Svenungsson and Sille Fløjborg and Robin Christensen and Anne Voss},
  journal = {Rheumatology advances in practice},
  year = {2026},
  month = oct,
  doi = {10.1093/rap/rkag126},
  url = {https://europepmc.org/article/MED/42948844},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Thoracic ultrasound finding interstitial lung disease in SLE: a diagnostic test accuracy study.
AU  - Henrik Zachar Langkilde
AU  - Bjørk K Sofíudóttir
AU  - Jesper Rømhild Davidsen
AU  - Stefan Markus Walbom Harders
AU  - Stefan Møller Luef
AU  - Susan Due Kay
AU  - Elisabet Svenungsson
AU  - Sille Fløjborg
AU  - Robin Christensen
AU  - Anne Voss
PY  - 2026
DA  - 2026/10/14
JO  - Rheumatology advances in practice
DO  - 10.1093/rap/rkag126
UR  - https://europepmc.org/article/MED/42948844
AB  - Objectives  Interstitial lung diseases (ILDs) are frequent and clinically important in SLE but diagnosis of ILD can be challenging. Thoracic ultrasound (TUS) shows promise in detecting ILD, hence, we aimed to evaluate the utility of TUS to identify ILD in SLE.Methods  Patients fulfilling the EULAR/ACR 2019 SLE classification criteria were invited. Participants were assessed for ILD by means of chest high-resolution computed tomography scans and pulmonary function tests and diagnosed at a multidisciplinary discussion, according to reference standards, independent of TUS. TUS evaluated the presence of B-lines and pleural abnormalities, blinded to status of ILD. The ability of B-lines to identify ILD using a prespecified threshold of ≥10 B-lines was analysed using diagnostic test accuracy measures. Further, we explored the diagnostic performance of B-lines and pleural abnormalities to identify ILD across various scenarios.Results  Among 185 patients with SLE, ILD were present in 22 (12%). With the predefined threshold of ≥10 B-lines, we found a modest diagnostic test accuracy as 14 of 22 ILD cases were classified as abnormal TUS, with diagnostic odds ratio of 10.7 (3.2-32.3), sensitivity of 64% (41-83%) and negative predictive value 97% (90-98%). In exploratory analyses, excluding participants with certain characteristics possibly affecting the TUS from the analyses improved the performance of TUS and pleural abnormalities were associated with ILD.Conclusion  In SLE, TUS focusing on the presence of B-lines demonstrated modest but statistically significant diagnostic test accuracy for detecting ILD. Pleural abnormalities were significantly associated to ILD.
SN  - 2514-1775
ER  -