Interstitial lung abnormalities detected incidentally on CT: a Position Paper from the Fleischner Society

2020

Conclusions

Early ILAs are common incidental findings on CT, particularly in older individuals. The presence of ILAs is an independent predictor of mortality. About 20% of ILAs progress over 2 years, and more than 40% progress over 5 years. Individuals with subpleural predominant fibrotic ILAs are most likely to progress.

Significance

ILAs (Interstitial lung abnormalities) are increasingly recognized as a common feature on CT scans, yet our understanding of these ILAs is still minimal with insufficient evidence to provide definitive management of them. Identification of ILAs is increasing with implementation of lung cancer screening programs, along with increased use of CT for other diagnostic purposes. The use of QCT metrics can help to identify, define, quantify, and mange ILAs overtime.

Not all ILAs will progress to ILDs but physicians need a way to help identify which ones will progress. There remains a need to standardize the definition of ILA’s vs ILD’s.
​Applicable Biomarkers:
  • Identify and quantify possible evidence of ILAs (HAA%).
  • Provide further characterization and quantification of ILA’s (Texture analysis).
  • Quantifications can be easily tracked over time for progression of ILAs.
  • Enhanced Visualizations can assist in determining risk for ILA progression

Hatabu, Hiroto, et al. “Interstitial lung abnormalities detected incidentally on CT: a Position Paper from the Fleischner Society.”The Lancet Respiratory Medicine8.7 (2020): 726-737.

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