Updated International Guidelines for IPF Diagnosis: A Radiology Perspective


RA-ILD Axial Image Series

Here we have a high-resolution cut through the chest. We can see quite clearly that there is a diffuse parenchymal abnormality involving all of the lobes seen in this view. There is a diffuse, reticular architectural distortion process occurring with regional volume loss in keeping with areas of fibrosis, and there is clearly significant traction bronchiectasis. There is no subpleural honeycombing on this series of images, but there clearly is a diffuse fibrotic process that appears to have a more central rather than subpleural distribution.

Radiologically, this patient clearly has fibrotic lung disease that is not typical of UIP and would not be definite UIP by definition. It would fall into the category of not typical of UIP, and one would look for an alternative cause of lung disease other than IPF.