imaging-features-systemic-sclerosis-associated-interstitial-lung

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Early diagnosis of systemic sclerosis-related interstitial lung disease (SSc-ILD) is important to enable treatment to be administered with minimal delay. ...

University of Chicago Medicine

To determine the effect of the MUC5B promoter polymorphism (rs35705950) on the CT imaging appearance of pulmonary fibrosis.

CT Imaging Phenotypes of Pulmonary Fibrosis in the MUC5B Promoter Site Polymorphism.

Multidisciplinary discussion is essential in establishing the diagnosis of idiopathic pulmonary fibrosis (IPF) and in determining prognosis.

The Value of a Multidisciplinary Approach to the Diagnosis of Usual Interstitial Pneumonitis and Idiopathic Pulmonary Fibrosis: Radiology, Pathology, and Clinical Correlation.

Idiopathic pulmonary fibrosis (IPF) is the most common fibrosing lung disease and is associated with a very poor prognosis. IPF manifests histopathologically as usual interstitial pneumonia (UIP) and as subpleural and basal predominant reticulation with honeycombing on high-resolution computed tomography (HRCT) of the chest. When a high-confidence radiologic diagnosis of UIP is made on HRCT, surgical biopsy is rarely required. Therefore, radiologists should recognize a UIP pattern on HRCT as well as recognize other patterns of fibrosing lung disease such as nonspecific interstitial pneumonia or chronic hypersensitivity pneumonitis, both of which can be mistaken for UIP. This article reviews the clinical, CT, and histopathologic features of IPF, discusses the impact of CT findings on prognosis, and describes complications associated with IPF. 

Idiopathic Pulmonary Fibrosis.

The Effect of an Electronic Peer-Review Auditing System on Faculty-Dictated Radiology Report Error Rates.

Impact of an Incentive Compensation Plan on Academic Productivity.

To identify CT findings in chronic hypersensitivity pneumonitis (cHP) associated with survival.

CT findings associated with survival in chronic hypersensitivity pneumonitis.

Incidental pulmonary findings are commonly detected at lung cancer screening chest CT. Though most of these findings are clinically insignificant, it is difficult to prospectively determine which are potentially important to clinical care. The purpose of this review is to discuss the incidental pulmonary findings commonly detected at lung cancer screening chest CT.

Screening for Lung Cancer: Incidental Pulmonary Parenchymal Findings.

Differentiating between systemic sclerosis-related interstitial lung disease (SSc-ILD) and idiopathic pulmonary fibrosis (IPF) is important because of the differences in workup, prognosis, and treatment. However, there is much overlap in the appearance of these 2 entities on high-resolution computed tomography. We propose that inflammation and/or fibrosis focally or disproportionately involving the bilateral anterolateral upper lobes and posterosuperior lower lobes ["Four Corners" Sign (FCS)] is specific for SSc-ILD.

The Four Corners Sign: A Specific Imaging Feature in Differentiating Systemic Sclerosis-related Interstitial Lung Disease From Idiopathic Pulmonary Fibrosis.

The Effect of a Technologist-Centered Electronic Review and Feedback System on Image Quality.

The purpose of this article was to determine whether a novel finding on coronal computed tomography (CT) can help differentiate usual interstitial pneumonia (UIP) from nonspecific interstitial pneumonia (NSIP) in order to obviate lung biopsy.

Differentiating Usual Interstitial Pneumonia From Nonspecific Interstitial Pneumonia Using High-resolution Computed Tomography: The "Straight-edge Sign".

The Value of a Disease-Specific Template and an IT-Based Quality Tracking System in Pulmonary Embolism CT Angiography.

The aim of this study was to assess national and state-specific changes in emergency department (ED) chest imaging utilization from 1994 to 2015.

Increasing Utilization of Chest Imaging in US Emergency Departments From 1994 to 2015.

In the appropriate clinical setting, the diagnosis of idiopathic pulmonary fibrosis (IPF) requires a pattern of usual interstitial pneumonia to be present on high-resolution chest CT (HRCT) or surgical lung biopsy. A molecular usual interstitial pneumonia signature can be identified by a machine learning algorithm in less-invasive transbronchial lung biopsy samples. We report prospective findings for the clinical validity and utility of this molecular test.

Use of a molecular classifier to identify usual interstitial pneumonia in conventional transbronchial lung biopsy samples: a prospective validation study.

Routine screening CT for the identification of COVID-19 pneumonia is currently not recommended by most radiology societies. However, the number of CTs performed in persons under investigation (PUI) for COVID-19 has increased. We also anticipate that some patients will have incidentally detected findings that could be attributable to COVID-19 pneumonia, requiring radiologists to decide whether or not to mention COVID-19 specifically as a differential diagnostic possibility. We aim to provide guidance to radiologists in reporting CT findings potentially attributable to COVID-19 pneumonia, including standardized language to reduce reporting variability when addressing the possibility of COVID-19. When typical or indeterminate features of COVID-19 pneumonia are present in endemic areas as an incidental finding, we recommend contacting the referring providers to discuss the likelihood of viral infection. These incidental findings do not necessarily need to be reported as COVID-19 pneumonia. In this setting, using the term "viral pneumonia" can be a reasonable and inclusive alternative. However, if one opts to use the term "COVID-19" in the incidental setting, consider the provided standardized reporting language. In addition, practice patterns may vary, and this document is meant to serve as a guide. Consultation with clinical colleagues at each institution is suggested to establish a consensus reporting approach. The goal of this expert consensus is to help radiologists recognize findings of COVID-19 pneumonia and aid their communication with other healthcare providers, assisting management of patients during this pandemic.

Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA.

Article	Year
CT Imaging Phenotypes of Pulmonary Fibrosis in the MUC5B Promoter Site Polymorphism. Chest\| PubMed ID: 26836909	2016
The Value of a Multidisciplinary Approach to the Diagnosis of Usual Interstitial Pneumonitis and Idiopathic Pulmonary Fibrosis: Radiology, Pathology, and Clinical Correlation. AJR. American journal of roentgenology\| PubMed ID: 26901003	2016
Idiopathic Pulmonary Fibrosis. Journal of thoracic imaging\| PubMed ID: 27043425	2016
The Effect of an Electronic Peer-Review Auditing System on Faculty-Dictated Radiology Report Error Rates. Journal of the American College of Radiology : JACR\| PubMed ID: 27245996	2016
Impact of an Incentive Compensation Plan on Academic Productivity. Journal of the American College of Radiology : JACR\| PubMed ID: 28017271	2017
CT findings associated with survival in chronic hypersensitivity pneumonitis. European radiology\| PubMed ID: 28687910	2017
Screening for Lung Cancer: Incidental Pulmonary Parenchymal Findings. AJR. American journal of roentgenology\| PubMed ID: 29231759	2018
The Four Corners Sign: A Specific Imaging Feature in Differentiating Systemic Sclerosis-related Interstitial Lung Disease From Idiopathic Pulmonary Fibrosis. Journal of thoracic imaging\| PubMed ID: 29346191	2018
The Effect of a Technologist-Centered Electronic Review and Feedback System on Image Quality. Journal of the American College of Radiology : JACR\| PubMed ID: 29503147	2018
Differentiating Usual Interstitial Pneumonia From Nonspecific Interstitial Pneumonia Using High-resolution Computed Tomography: The "Straight-edge Sign". Journal of thoracic imaging\| PubMed ID: 29683868	2018
The Value of a Disease-Specific Template and an IT-Based Quality Tracking System in Pulmonary Embolism CT Angiography. Journal of the American College of Radiology : JACR\| PubMed ID: 29748079	2018
Increasing Utilization of Chest Imaging in US Emergency Departments From 1994 to 2015. Journal of the American College of Radiology : JACR\| PubMed ID: 30611682	2019
Use of a molecular classifier to identify usual interstitial pneumonia in conventional transbronchial lung biopsy samples: a prospective validation study. The Lancet. Respiratory medicine\| PubMed ID: 30948346	2019
Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Ra... Journal of thoracic imaging\| PubMed ID: 32324653	2020

Jonathan H. Chung

Biography

JoVE Journal Publications

Other Publications