Full Papers
Diagnostic accuracy of lung ultrasound in identifying connective tissue disease related interstitial lung disease: a systematic review and meta-analysis
D. Du1, J. Qin2, G. Zhang3, Z. Liu4, L. Gao5, Y. Wu6, Z. Chen7, D. Li8, F. Luo9, Y. Shen10
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu; and Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China.
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; and State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China.
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu; and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, West China Hospital, Sichuan University, Chengdu, China.
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu; and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, West China Hospital, Sichuan University, Chengdu, China.
- Department of Medical Affairs, West China Hospital, Sichuan University, Chengdu, China.
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu; and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, West China Hospital, Sichuan University, Chengdu, China.
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu; and Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China. fengmingluo@outlook.com
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu; Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, West China Hospital, Sichuan University, Chengdu; and Sichuan Public Health General Clinical Center, Chengdu, China. shen_yongchun@126.com
CER19691
Full Papers
Received: 14/01/2026
Accepted : 02/03/2026
In Press: 18/06/2026
Abstract
OBJECTIVES:
The diagnosis of connective tissue disease-associated interstitial lung disease (CTD-ILD) primarily relies on high-resolution computed tomography or lung biopsy, while several challenges persist in the clinical application of these modalities. This study aims to investigate the performance of lung ultrasound (LUS) in diagnosis of ILD in patients with CTD.
METHODS:
Records from five electronic databases were screened and selected for eligible studies. Quality assessment of eligible studies was performed via Quality Assessment of Diagnostic Accuracy Studies-2. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve (AUC) of LUS was calculated. Sensitivity analyses, subgroup analyses and meta-regression were applied to identify sources of heterogeneity.
RESULTS:
Twenty-eight eligible studies were selected from 417 records, with a total of 2,196 participants (1,117 with CTD-ILD and 1,079 CTD patients without ILD). All studies reached moderate to high quality. LUS has shown good diagnostic performance in detecting CTD-ILD, with a sensitivity of 0.92, a specificity of 0.88 and an AUC of 0.96. Further stratified analyses suggested that good performance of LUS was also observed in diagnosing rheumatoid arthritis-associated ILD (sensitivity: 0.91, specificity: 0.90, AUC: 0.96) and systemic sclerosis-associated ILD (sensitivity: 0.96, specificity: 0.78, AUC: 0.94). Significant heterogeneity and publication bias was observed.
CONCLUSIONS:
Although LUS has shown good performance in diagnosing CTD-ILD, this approach does not yet justify routine application due to heterogeneity and publication bias. Further studies may focus on performance of LUS in other subtypes of CTD-ILD.
