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Updated: Oct 25, 2025
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Interstitial Lung Abnormalities: State of the Art
Akinori Hata1, Mark L Schiebler1, David A Lynch1
1From the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (A.H., H.H.); Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (A.H.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.).
Interstitial lung abnormality (ILA) is a common CT finding linked to worse outcomes. Radiologists play a key role in identifying ILA, assessing risk, and guiding patient management for better clinical outcomes.
Area of Science:
- Radiology
- Pulmonology
- Medical Imaging
Background:
- Interstitial lung abnormality (ILA) is an increasingly recognized clinical finding.
- ILA is often an incidental finding on CT scans, frequently progressive, and associated with increased mortality.
- Risk factors for ILA include age, smoking, inhalational exposures, and genetic factors.
Purpose of the Study:
- To summarize the definition, evidence, management, and challenges of ILA from a radiologic perspective.
- To provide a practical guide for radiologists in managing ILA.
- To highlight the importance of radiologic assessment in predicting ILA progression and patient outcomes.
Main Methods:
- Review of the Fleischner Society's 2020 position paper on ILA.
- Analysis of existing evidence on ILA definition, risk factors, and clinical significance.
- Discussion of radiologic characteristics, subcategories, and follow-up strategies for ILA.
Main Results:
- ILA is a common incidental CT finding with mortality hazard ratios from 1.3 to 2.7.
- Systematic radiologic recording of ILA characteristics aids in predicting progression and mortality.
- ILA requires differentiation from clinically significant interstitial lung disease.
Conclusions:
- Radiologists are crucial for identifying, characterizing, and managing ILA.
- Risk stratification and systematic follow-up are recommended for higher-risk ILA patients.
- Further validation of AI in ILA analysis is needed, with radiologists central to ongoing research.
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