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Updated: May 15, 2025

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Updates in Diagnostic Tools for ILD.

Arsal Tharwani1, Manuel L Ribeiro Neto1

  • 1Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Journal of Clinical Medicine
|May 14, 2025
PubMed
Summary
This summary is machine-generated.

New diagnostic tools for interstitial lung disease (ILD) improve accuracy. While surgical lung biopsy (SLB) is the gold standard, emerging methods like genomic classifiers and transbronchial cryobiopsy offer promising yields with lower risks.

Keywords:
biopsydiagnosisinterstitial lung diseases

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Area of Science:

  • Pulmonology
  • Diagnostic Imaging
  • Pathology

Background:

  • Interstitial lung disease (ILD) diagnosis often relies on multidisciplinary discussion (MDD).
  • Histopathology enhances diagnostic confidence in challenging ILD cases.
  • The range of tools for obtaining ILD histopathological samples is expanding.

Purpose of the Study:

  • To review emerging and established diagnostic modalities for ILD.
  • To evaluate the sensitivity, specificity, and complication rates of these tools.
  • To compare the diagnostic yield of various ILD diagnostic methods.

Main Methods:

  • Systematic literature review of PubMed publications.
  • Focus on clinical trials, cohort studies, and systematic reviews.
  • Extracted data on diagnostic yield, specificity, sensitivity, and procedural complications for genomic classifier (GC), transbronchial cryobiopsy (TBLC), surgical lung biopsy (SLB), endobronchial ultrasound cryobiopsy (EBUS-C), genetic testing, and transthoracic echocardiography (STE).

Main Results:

  • Genomic classifier (GC) shows high specificity for usual interstitial pneumonia (UIP) but may require further invasive sampling.
  • Transbronchial cryobiopsy (TBLC) provides larger samples, increasing diagnostic yield and confidence at MDD, with 63-77% interobserver agreement compared to SLB.
  • Surgical lung biopsy (SLB) remains the gold standard (>90% yield), while EBUS-C shows promise for sarcoidosis/lymphoma diagnosis. All methods carry procedural risks.

Conclusions:

  • Advancements in diagnostic tools have significantly improved ILD diagnostic accuracy.
  • Alternative modalities like TBLC and GC offer promising yields and lower procedural risks compared to SLB.
  • The choice of diagnostic modality should balance diagnostic yield, specificity, and procedural risk.