Diffuse lung disease: diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung.

Swensen, Stephen J.; Aughenbaugh, Gregory L.; Myers, Jeffrey L.

doi:10.1148/radiology.205.1.9314990

Cited by 175 publications

(99 citation statements)

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“…Several studies have documented that the positive predictive value of a HRCT diagnosis of UIP is 90 to 100% (103)(104)(105)(106)(107)(108). These studies are affected by selection bias because they only included patients with biopsy-proven diagnoses.…”

Section: Definition Of Uip Pattern Uip Pattern: Hrct Featuresmentioning

confidence: 99%

An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management

Raghu¹,

Collard²,

Egan³

et al. 2011

Am J Respir Crit Care Med

6,330

7,347

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Section: Definition Of Uip Pattern Uip Pattern: Hrct Featuresmentioning

confidence: 99%

An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management

Raghu¹,

Collard²,

Egan³

et al. 2011

Am J Respir Crit Care Med

6,330

7,347

View full text Add to dashboard Cite

“…As suggested above, a diagnosis of definite IPF is not usually possible from HRCT appearances alone in at least one-third of cases [3,18]. As suggested in the 2000 guidelines, the revised 2011 guidelines appropriately recommend that a SLB should be performed when patients present with nondiagnostic scans or if the diagnosis of definite IPF is uncertain [2,11].…”

Section: Surgical Lung Biopsymentioning

confidence: 99%

Managing diagnostic procedures in idiopathic pulmonary fibrosis

Wells

2013

Eur Respir Rev

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Idiopathic pulmonary fibrosis (IPF), the most prevalent of the idiopathic interstitial pneumonias, is associated with a poor prognosis. An accurate diagnosis of IPF is essential for its optimal management. The 2011 American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/Latin American Thoracic Association (ALAT) recommendations on the diagnosis and management of IPF were developed from a systematic review of the published literature. High-resolution computed tomography (HRCT) scanning has a central role in the IPF diagnostic pathway, with formal designation of criteria for an HRCT pattern of usual interstitial pneumonia. In the correct clinical context, a usual interstitial pneumonia pattern on HRCT is indicative of a definite diagnosis of IPF and negates the need for a surgical lung biopsy. However, although the 2011 ATS/ERS/JRS/ALAT statement is a major advance, the application of the guideline recommendations by clinicians has identified limitations that should be addressed in future statements. Key problems include: 1) HRCT misdiagnosis, particularly by less experienced radiologists; 2) lack of management recommendations for the highly prevalent clinical scenarios of “probable” or “possible” IPF; 3) ongoing confusion concerning the diagnostic role of bronchoalveolar lavage; and 4) the lack of integration of clinical data in the designation of the diagnostic likelihood of IPF, including the treated course of disease. These issues become evident as the recommendations are applied and highlight the need for continued guideline adjustments.

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“…However, since the positive predictive value of the HRCT findings of the usual interstitial pneumonia (UIP) pattern for a diagnosis of IPF/UIP is o85% and a confident diagnosis of UIP by experienced radiologists can be made in 95% of cases with the characteristic pattern of UIP on HRCT images [38][39][40][41], invasive procedures including bronchoscopy, BAL and transbronchial lung biopsy may not be required to make a confident diagnosis of IPF in the appropriate clinical setting [9]. In fact, the features of the criteria for the UIP pattern has been precisely described in the new joint American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/Asociació n Latinoamericana del Tórax (ALAT) statement; the new guideline states that the presence of the described UIP pattern on HRCT imaging is sufficient to make a diagnosis of IPF in the appropriate clinical setting and eliminates the need for BAL cellular analyses [42,43].…”

Section: Bal Characteristics and The Diagnosis Of Specific Types Of Ildmentioning

confidence: 99%

Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful?

Meyer¹,

Raghu²

2011

Eur Respir J

122

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Although the application of thoracic high-resolution computed tomography (HRCT) to clinical pulmonology has revolutionised the diagnostic approach to patients with suspected interstitial lung disease (ILD), additional testing is often needed to make a confident ILD diagnosis.Bronchoalveolar lavage (BAL) can play a significant role in making an accurate and confident diagnosis of specific forms of ILD. When BAL is used in conjunction with comprehensive clinical information and HRCT, BAL nucleated immune cell patterns can frequently provide useful information for diagnostic evaluation and lessen the need to proceed to more invasive procedures, such as surgical lung biopsy.Additionally, BAL can identify confounding conditions, such as infection or malignancy. However, BAL technique, and protocols for processing and analysing BAL fluid are critically important for providing useful information.This perspective reviews the current status of using BAL as a diagnostic tool for the diagnosis of ILD.

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Diffuse lung disease: diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung.

Abstract: In a subset of patients with diffuse lung disease who undergo surgical biopsy, accurate diagnosis can be made with CT findings only.

Cited by 175 publications

References 0 publications

An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management

An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management

Managing diagnostic procedures in idiopathic pulmonary fibrosis

Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful?

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