Interpretation of HRCT Scans in the Diagnosis of IPF: Improving Communication Between Pulmonologists and Radiologists.
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease (ILD). In this review, we describe the central role of high-resolution computed tomography (HRCT) in the diagnosis of IPF and discuss how communication between pulmonologists and radiologists might be improved to make the interpretation of HRCT scans more effective. Clinical information is important in the interpretation of HRCT scans, as the likelihood that specific radiologic features reflect IPF is not absolute, but dependent on the clinical context. In cases where the clinical context or HRCT pattern are inconclusive, multidisciplinary discussion (MDD) between a pulmonologist and radiologist (and, where relevant, a pathologist and rheumatologist) experienced in the differential diagnosis of ILD is necessary to establish a diagnosis. While it can be challenging to convene a face-to-face meeting, MDD can be conducted virtually or by telephone to enable each specialty group to contribute. To make the MDD most effective, it is important that relevant clinical information (for example, on the patient's clinical history, exposures and the results of serological tests) is shared with all parties in advance. A common lexicon to describe HRCT features observed in ILD can also help improve the effectiveness of MDD. A working diagnosis may be made in patients who do not fulfill all the diagnostic criteria for any specific type of ILD, but this diagnosis should be reviewed at regular intervals, with repeat of clinical, radiological, and laboratory assessments as appropriate, as new information pertinent to the patient's diagnosis may become available.
['Chung|Jonathan H|JH|http://orcid.org/0000-0001-7011-0588', 'Goldin|Jonathan G|JG|']
D000368:Aged D005260:Female D006801:Humans D054990:Idiopathic Pulmonary Fibrosis D033183:Interdisciplinary Communication D008297:Male D008487:Medical History Taking D008875:Middle Aged D000072142:Pathologists D000072106:Pulmonologists D000072177:Radiologists D000072140:Rheumatologists D012698:Serologic Tests D014057:Tomography, X-Ray Computed
Idiopathic pulmonary fibrosis Interstitial lung disease High-resolution computed tomography Multidisciplinary discussion Diagnostic criteria