Practice patterns in reporting interstitial lung abnormality at a tertiary academic medical center

Area of Science:

• Pulmonary Medicine
• Radiology
• Thoracic Imaging

Background:

• Interstitial lung abnormality (ILA) is a common chest CT finding linked to mortality.
• The 2020 Fleischner Society guidelines standardized ILA terminology.
• Radiologist adoption of standardized ILA terminology remains unclear.

Purpose of the Study:

• Evaluate radiologist practice patterns for identifying interstitial lung abnormalities.
• Assess the use of the term ILA post-Fleischner Society guidelines.
• Determine adherence to standardized ILA terminology in clinical practice.

Main Methods:

• Retrospective review of 157 radiology reports (2010-2021) mentioning interstitial lung abnormality.
• Exclusion of reports, followed by review of 125 CT scans by thoracic radiologists.
• Sequential reading method applied to assess ILA presence and classification.

Main Results:

• 62% of reviewed scans showed interstitial lung abnormality (ILA).
• ILA term use surged post-2020 guidelines, primarily by thoracic radiologists.
• Mild ILA (1-25% lung involvement) was most common; 31% of clinical ILA diagnoses were reclassified.

Conclusions:

• Thoracic radiologists increasingly adopt the term ILA, aligning with guidelines.
• Non-thoracic radiologists show minimal adoption of the term ILA.
• Discrepancies exist between clinical and expert ILA classification, highlighting potential for improved diagnostic accuracy.