The role of high-resolution computed tomography in the work-up of interstitial lung disease

Purpose of review This paper reviews several studies that have concentrated on the diagnostic and prognostic information that can be obtained with high-resolution computed tomography (HRCT) and that show how this information can be used and interpreted in conjunction with the clinical and the pathologic information. Recent findings HRCT, nowadays usually performed with spiral CT, is very often able to make the correct diagnosis of diffuse parenchymal and interstitial lung disease, especially when typical CT patterns of this disease are present, a reason why lung biopsy may be avoided. However, when CT signs are atypical, a diagnosis may only be possible after thorough clinicoradiologic correlation. In case of discordance, a lung biopsy may be indicated, necessitating again a formal multidisciplinary discussion. HRCT can also be a valuable tool in predicting prognosis. Summary HRCT plays an important role in the detection, diagnosis and follow-up of diffuse parenchymal and interstitial lung disease and may be very helpful in predicting prognosis. In patients in whom typical CT features are present, diagnosis can often be suggested, whereas signs of fibrosis have important prognostic implications. However, in order to increase the chance of a correct diagnosis, a formal multidisciplinary approach is necessary.