PT - JOURNAL ARTICLE AU - Ciet, Pierluigi AU - Bertolo, Silvia AU - Ros, Mirco AU - Casciaro, Rosaria AU - Cipolli, Marco AU - Colagrande, Stefano AU - Costa, Stefano AU - Galici, Valeria AU - Gramegna, Andrea AU - Lanza, Cecilia AU - Lucca, Francesca AU - Macconi, Letizia AU - Majo, Fabio AU - Paciaroni, Antonella AU - Parisi, Giuseppe Fabio AU - Rizzo, Francesca AU - Salamone, Ignazio AU - Santangelo, Teresa AU - Scudeller, Luigia AU - Saba, Luca AU - Tomà, Paolo AU - Morana, Giovanni TI - State-of-the-art review of lung imaging in cystic fibrosis with recommendations for pulmonologists and radiologists from the “iMAging managEment of cySTic fibROsis” (MAESTRO) consortium AID - 10.1183/16000617.0173-2021 DP - 2022 Mar 31 TA - European Respiratory Review PG - 210173 VI - 31 IP - 163 4099 - http://err.ersjournals.com/content/31/163/210173.short 4100 - http://err.ersjournals.com/content/31/163/210173.full SO - EUROPEAN RESPIRATORY REVIEW2022 Mar 31; 31 AB - Objective Imaging represents an important noninvasive means to assess cystic fibrosis (CF) lung disease, which remains the main cause of morbidity and mortality in CF patients. While the development of new imaging techniques has revolutionised clinical practice, advances have posed diagnostic and monitoring challenges. The authors aim to summarise these challenges and make evidence-based recommendations regarding imaging assessment for both clinicians and radiologists.Study design A committee of 21 experts in CF from the 10 largest specialist centres in Italy was convened, including a radiologist and a pulmonologist from each centre, with the overall aim of developing clear and actionable recommendations for lung imaging in CF. An a priori threshold of at least 80% of the votes was required for acceptance of each statement of recommendation.Results After a systematic review of the relevant literature, the committee convened to evaluate 167 articles. Following five RAND conferences, consensus statements were developed by an executive subcommittee. The entire consensus committee voted and approved 28 main statements.Conclusions There is a need for international guidelines regarding the appropriate timing and selection of imaging modality for patients with CF lung disease; timing and selection depends upon the clinical scenario, the patient's age, lung function and type of treatment. Despite its ubiquity, the use of the chest radiograph remains controversial. Both computed tomography and magnetic resonance imaging should be routinely used to monitor CF lung disease. Future studies should focus on imaging protocol harmonisation both for computed tomography and for magnetic resonance imaging. The introduction of artificial intelligence imaging analysis may further revolutionise clinical practice by providing fast and reliable quantitative outcomes to assess disease status. To date, there is no evidence supporting the use of lung ultrasound to monitor CF lung disease.There is a need for international guidelines regarding the appropriate timing and selection of imaging modality for patients with cystic fibrosis lung disease. https://bit.ly/3HwjUvG