High-resolution CT of interstitial lung disease: a continuous evolution.

Area of Science:

• Radiology
• Pulmonology
• Medical Imaging

Background:

• Chest radiography had limited utility in interstitial lung disease (ILD) management prior to advanced imaging.
• High-resolution computed tomography (HRCT) emerged in the late 1980s, significantly enhancing lung imaging capabilities.
• HRCT provides detailed cross-sectional views, enabling precise identification of various ILDs.

Purpose of the Study:

• To review the evolutionary stages of high-resolution computed tomography's role in diagnosing interstitial lung diseases.
• To examine the shift from histopathology as the sole reference standard to integrating HRCT findings.
• To discuss the incorporation of HRCT data with pulmonary function for prognostic staging.

Main Methods:

• Review of HRCT investigations in interstitial lung disease from the late 1980s to the present.
• Analysis of HRCT-pathologic correlative studies that defined basic HRCT patterns.
• Examination of the evolving perception of histopathology's role and the rise of multidisciplinary approaches.

Main Results:

• HRCT established a pattern recognition approach for ILD diagnosis, correlating imaging with histopathology.
• HRCT's utility expanded to predicting disease reversibility and responsiveness.
• Recent advancements integrate HRCT with pulmonary function tests for improved prognostic models, especially in idiopathic pulmonary fibrosis.

Conclusions:

• High-resolution computed tomography has become the dominant, indispensable imaging technique for interstitial lung diseases.
• The role of HRCT has evolved significantly, moving beyond initial pattern recognition to encompass prognostic assessment.
• The integration of HRCT with clinical and functional data, alongside multidisciplinary input, represents the current standard of care for ILD.