Fast Five Quiz: Idiopathic Pulmonary Fibrosis Imaging

Ani Kapoor, MD; Zab Mosenifar, MD


June 21, 2022

HRCT scans reportedly show honeycombing in 90% of patients with IPF. However, in the absence of honeycombing, the extent of reticular and ground-glass densities can predict a diagnosis of IPF. The probability of IPF exceeds 80% in patients older than 60 years with extent of reticular density one third or more of total lung volume, according to Salisbury and colleagues.

When evaluating a patient for suspected IPF, HRCT findings of > 30% ground-glass attenuation should prompt the consideration of other diagnoses, including desquamative interstitial pneumonitis, idiopathic bronchiolitis obliterans organizing pneumonia, respiratory bronchiolitis–associated interstitial lung disease, hypersensitivity pneumonitis, and nonspecific interstitial pneumonia.

Ground-glass attenuations are relatively uncommon in IPF; reticular attenuations and honeycombing are more common.

Diagnostic accuracy of IPF is significantly increased with HRCT compared with chest radiography. When a trained observer performs an HRCT, the accuracy of the diagnosis is reported to be about 90%. A confident diagnosis of IPF is made in about two thirds of cases, whereas one third of cases are missed on HRCT.

Learn more about HRCT in IPF.


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