Interstitial Lung Abnormality: Recognition and Perspectives.
Radiology. 2019 Apr;291(1):1-3. doi: 10.1148/radiol.2018181684. Epub 2018 Dec 18.
Hatabu H1, Hunninghake GM1, Lynch DA1.
There is increasing awareness of the clinical importance of incidentally detected interstitial lung abnormalities (ILAs) on noncontrast chest CT scans. Both at the American Thoracic Society meeting in San Diego, Calif, and the Fleischner Society meeting in Dublin, Ireland, in the early summer of 2018, the emerging concept of ILAs was a highly discussed topic among researchers, pathologists, radiologists, pulmonologists, and industry representatives. An ILA refers to a subtle or mild parenchymal abnormality identified in more than 5% of lungs on CT scans in patients in whom interstitial lung disease was not previously clinically suspected (Fig 1). ILAs are currently reported on CT examinations as follows: (a) incidental findings of no significance, (b) findings of uncertain clinical significance, (c) age-related changes of no clinical significance, (d) findings are appreciated but not mentioned, or (e) findings not observed by the reporting radiologist (1). Most often, even if observed, these changes fall below the reporting threshold. Recent evidence has shown that an ILA is not a benign finding. Thus, observing these changes and reporting their presence on CT scans of the chest has prognostic value.