Computer-Aided Evaluation of Interstitial Lung Diseases

The approach for the diagnosis and treatment of interstitial lung diseases (ILDs) has changed in recent years, mainly for the identification of new entities, such as interstitial lung abnormalities (ILAs) and progressive pulmonary fibrosis (PPF). Clinicians and radiologists are facing new challenges for the screening, diagnosis, prognosis, and follow-up of ILDs. The detection and classification of ILAs or the identification of fibrosis progression at high-resolution computed tomography (HRCT) is difficult, with high inter-reader variability, particularly for non-expert radiologists. In the last few years, various software has been developed for ILD evaluation at HRCT, with excellent results, equal to or more reliable than humans. AI tools can classify ILDs, quantify the extent, analyze the features hidden from the human eye, predict prognosis, and evaluate the progression of the disease. More advanced tools can incorporate clinical and radiological data to obtain personalized prognosis, with the potential ability to steer treatment decisions. To step forward and implement in daily practice such tools, more collaboration is required to collect more homogeneous clinical and radiological data; furthermore, more robust, prospective trials, with the new AI-derived biomarkers compared with each other, are needed to demonstrate the real reliability of the computer-aided evaluation of ILDs.