Jonathan Goldin, MD, PhD, professor at the David Geffen School of Medicine at UCLA, explores high-resolution computed tomography (HRCT) in the diagnosis of idiopathic pulmonary fibrosis in a video entitled “The Role of HRCT in Diagnosing ILDs.”
HRCT plays a central role in the diagnosis of IPF—one of many interstitial lung diseases (ILDs) and the most common cause of usual interstitial (between the spaces of the lungs) pneumonia (UIP). The following criteria must be present for accurate IPF diagnosis:
1. Exclusion of other causes of interstitial lung disease (ILD), and
2. Presence of definite usual interstitial pneumonia (UIP) pattern on HRCT, or
3. Presence of possible UIP pattern on HRCT and lung biopsy showing definite/probable UIP
A UIP pattern shows areas of normality, interstitial inflammation, fibrosis (scarring) and honeycombing. Honeycombing refers to small cysts under the membrane covering the lungs. It is considered a specific finding for fibrosis and the most relevant diagnostic feature of a UIP pattern.
Finding a definite UIP pattern on HRCT is diagnostic of IPF, without need of surgical lung biopsy to confirm. However, HRCT findings consistent with possible or probable UIP, or inconsistent with UIP, typically require lung biopsy to confirm IPF.
Possible or inconsistent HRCT findings usually encompass most or all of those seen with a definite UIP pattern, except honeycombing.
The video can be seen in its entirety at:
(Insights in IPF is sponsored by Boehringer Ingelheim Pharmaceuticals, Inc.)