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REVIEW  HRCT OF THE CHEST IN ILD 

Journal of Radiological Review 2021 June;8(2):113-20

DOI: 10.23736/S2723-9284.21.00128-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Update on interstitial lung abnormalities

Giancarlo CORTESE 1 , Paola NESPOLI 1, Roberto PLACIDO 1, Clara PIATTI 2, Andrea GARNERO 2, Marco BUSSO 2, Nicola SVERZELLATI 3, Anna Rita LARICI 4, 5

1 Department of Radiology, Maria Vittoria Hospital, Turin, Italy; 2 Department of Radiology, AOU San Luigi Gonzaga, Orbassano, Turin, Italy; 3 Section of Diagnostic Imaging, Department of Clinical Sciences, University of Parma, Parma, Italy; 4 Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, “A. Gemelli” University Polyclinic Foundation IRCCS, Rome, Italy; 5 Department of Radiological and Hematological Sciences, Section of Radiology, Catholic University of the Sacred Heart of Rome, Rome, Italy



Interstitial lung abnormalities (ILAs) represent a set of radiological findings incidentally detected on chest HRCT (high-resolution computed tomography) predominantly in older patients (>60 years) without any clinical suspicion of lung disease. Initially described in smokers undergoing lung cancer screening programs, ILAs were subsequently observed also in the general population. ILAs usually are poorly evolving interstitial lung alterations, but they may also represent the early preclinical phase of a progressive interstitial disease with unfavorable prognosis. Moreover, ILAs may represent an important risk factor for the development of acute lung damage after chemo-radiotherapy. When recognized on a CT scan of optimal quality, it is essential to accurately report findings indicative of ILAs, distinguishing fibrotic from non-fibrotic abnormalities. In the subset of ILAs presenting the pattern of a fibrotic interstitial lung disease in a preclinical phase, the clinical-therapeutic management is based on guidelines published in the current literature. ILAs with a less obvious fibrotic appearance are more difficult to manage; even after clinical evaluation, it is not always easy to choose between an immediate invasive diagnostic approach or a follow-up. Schedule and duration of the follow-up are also not clearly defined in the current literature. The careful evaluation of the cost-benefit ratio of the different diagnostic and therapeutic options available must be the cornerstone in the ILAs diagnostic process, pending further clarification from literature. The purpose of this article was to provide an up-to-date review of the current available literature on ILAs.


KEY WORDS: Lung diseases, interstitial; Pulmonary fibrosis; Review

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