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Imaging biomarkers and staging in IPF

Walsh, Simon L.F.

Current Opinion in Pulmonary Medicine: September 2018 - Volume 24 - Issue 5 - p 445–452
doi: 10.1097/MCP.0000000000000507
INTERSTITIAL LUNG DISEASE: Edited by Francesco Bonella and Paolo Spagnolo

Purpose of review The application of computer-based imaging analysis in patients with idiopathic pulmonary fibrosis is a rapidly developing field. The purpose of this review is to provide insights into the problems associated with visual interpretation of HRCT patterns and describe some of the current technologies used to provide objective quantification of disease on HRCT. Future directions are also discussed.

Recent findings Although there is strong evidence that visual quantification of disease on HRCT in idiopathic pulmonary fibrosis provides prognostic information, this approach is hampered by its subjective nature and interobserver variability. In contrast, computer-based quantification of disease on HRCT provides objective and reproducible data, which may help to predict mortality and time to decline in patients with idiopathic pulmonary fibrosis. The use of these technologies may also help to stratify clinical risk in patients enrolled in drug trials.

Summary The future of imaging-based biomarker research in idiopathic pulmonary fibrosis is undoubtedly computer-based HRCT evaluation. However, if this field is to continue to innovate, large, well annotated imaging datasets for developing and testing. new computer-based tools are needed as well as prospective trials for biomarker validation.

Department of Radiology, King's College Hospital Foundation Trust, Denmark Hill, Brixton, London SE5 9RS, United Kingdom

Correspondence to Simon L.F. Walsh, Department of Radiology, King's College Hospital Foundation Trust, Denmark Hill, Brixton, London SE5 9RS, United Kingdom. Tel: +44 20 3299 4164; fax: +44 20 3299 3157; e-mail: slfwalsh@gmail.com

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