High resolution computed tomography patterns in interstitial lung disease (ILD): prevalence and prognosis

Area of Science:

• Radiology
• Pulmonology
• Pathology

Background:

• Interstitial lung disease (ILD) diagnosis relies on integrating clinical, radiological, and pathological findings.
• High-resolution computed tomography (HRCT) patterns are crucial for diagnosing idiopathic pulmonary fibrosis (IPF) and other ILDs.
• Classifying HRCT patterns of usual interstitial pneumonia (UIP) aids in differential diagnosis and prognosis.

Purpose of the Study:

• To correlate HRCT patterns of typical, probable, and indeterminate UIP with the final multidisciplinary diagnosis of ILD.
• To evaluate the prognostic significance of HRCT-based UIP patterns in ILD patients.

Main Methods:

• Retrospective analysis of 244 patients with a multidisciplinary ILD diagnosis and HRCT patterns of typical, probable, or indeterminate UIP.
• Inclusion of clinical, histopathological, pulmonary function, and survival data.
• Validation of final diagnoses by a multidisciplinary team.

Main Results:

• In patients with typical UIP HRCT patterns, IPF was diagnosed in 62%, chronic hypersensitivity pneumonitis (CHP) in 20%, and connective tissue disease-related ILD (CTD-ILD) in 10%.
• For probable UIP HRCT patterns, CTD-ILD was 39%, IPF 31%, and desquamative interstitial pneumonia 11%.
• Patients with typical UIP HRCT patterns showed higher rates of mortality (17.9%) and lung transplantation (11.3%).

Conclusions:

• IPF, CHP, and CTD-ILD are key differential diagnoses for HRCT patterns categorized as typical, probable, or indeterminate UIP.
• A typical UIP HRCT pattern is associated with a poorer prognosis, including increased mortality and lung transplantation rates.