Novel Quantitative Lung Ultrasound Spectroscopy Approach to differentiate Acute Exacerbation of Pulmonary Fibrosis from Pulmonary Fibrosis – preliminary results from SAURON Study

In SAURON Study [<ext-link>NCT06068647</ext-link>], a novel approach is investigated to standardize imagine segmentation and use of radiofrequency (RF) data derived from spectroscopy analysis to differentiate between Acute Exacerbation of Pulmonary Fibrosis (AEPF) from Pulmonary Fibrosis (PF). The preliminary dataset is composed of RF multifrequency data acquired by an ULA-OP research scanner connected to a linear probe. Thirty-two patients were enrolled at Policlinico Universitario A. Gemelli in Rome. Twelve patients suffered from AEPF and 20 from PF. Ten areas for each patient were scanned. Each scan was composed of 23 multifrequency frames obtained by four different center frequency: 3, 4, 5 e 6 MHz. In total, 5429 frames were segmented into three regions, based on pleural line as region of interest (ROI): pre-pleura, pleura and post pleura, respectively numbered as 1, 2 and 3. For each segment, total intensity, center frequency and bandwidth were analysed. Both univariate and multivariate analysis were conducted to evaluate the ability of the variables to discriminate between the two conditions. Binomial logistic regression was performed to evaluate the potential to diagnosis AEPF. In this study, a quantitative spectroscopy analysis was applied to differentiate AEPF from PF. Binomial logistic regression showed the possibility to identify patients with AEPF with a sensitivity of 84.5%. Future studies are needed to externally validate the role of these features.