HRCT Interpretation Session (2021)-T1-CCH01-2021

Video Transcription

Video Summary

The RSNA session titled "HRCT of Interstitial Lung Disease: Interactive Read with Experts" focused on the challenges of diagnosing interstitial lung diseases, particularly idiopathic interstitial pneumonias (IIPs), which often defy neat classification. Dr. Jeff Galvin, along with a panel of international experts, discussed the diagnostic criteria used for identifying idiopathic pulmonary fibrosis (IPF) and other fibrosing interstitial pneumonias. The session stressed the importance of distinguishing usual interstitial pneumonia (UIP), which can be either primary or secondary, from other conditions like nonspecific interstitial pneumonia (NSIP) and chronic hypersensitivity pneumonitis, as they have varied prognoses and treatment plans.<br /><br />Professor David Lynch highlighted the criteria for diagnosing UIP using imaging patterns, emphasizing the characteristic features such as subpleural and basal predominance, reticular abnormalities, and honeycombing. He cautioned about the subjectivity in diagnosing these patterns, where factors like peribronchovascular extension and degree of ground glass opacities influence the classification into certain probability categories: definite UIP, probable UIP, indeterminate, or consistent with an alternative diagnosis.<br /><br />The session explored how HRCT imaging aids clinicians in conveying prognosis and treatment options to patients, noting the improved outcomes due to available treatments despite UIP's traditionally poor prognosis. Through case presentations, the panelists showcased varied presentations of interstitial lung diseases and stressed that understanding the heterogeneity and imaging appearances across the spectrum of diffuse lung diseases remains a diagnostic challenge in clinical radiology practice.

Keywords

HRCT

Interstitial Lung Disease

Idiopathic Interstitial Pneumonias

Idiopathic Pulmonary Fibrosis

Usual Interstitial Pneumonia

Nonspecific Interstitial Pneumonia

Chronic Hypersensitivity Pneumonitis

Diagnostic Criteria

Imaging Patterns

Prognosis

Treatment Options

Clinical Radiology