ArticleRespiratory research2021
Practical application and validation of the 2018 ATS/ERS/JRS/ALAT and Fleischner Society guidelines for the diagnosis of idiopathic pulmonary fibrosis.
Article in Respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Radiologic patterns of interstitial lung disease: a pictorial review based on the 2025 European Respiratory Society/American Thoracic Society Classification.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Review
- The 2025 ATS/ERS update of the international multidisciplinary classification of the interstitial pneumonias: implications for the pathologist.Histopathology · 2026Review
- From Inflammation to Precision Medicine: Mechanistic Insights into Asthma, COPD, and IPF.Biomedicines · 2026Review
- Influence of content-based image retrieval on the accuracy and inter-reader agreement of usual interstitial pneumonia CT pattern classification.European radiology · 2025Article
- Cost-effectiveness of novel diagnostic tools for idiopathic pulmonary fibrosis in the United States.BMC health services research · 2025Article
- Identification of early genes in the pathophysiology of fibrotic interstitial lung disease in a new model of pulmonary fibrosis.Cellular and molecular life sciences : CMLS · 2025Article
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- Prognostic Value of Serum Biomarkers in Patients with Idiopathic Pulmonary Fibrosis in Relation to Disease Progression.Journal of personalized medicine · 2023Article
- AI support for accurate and fast radiological diagnosis of COVID-19: an international multicenter, multivendor CT study.European radiology · 2023Article
- Usual interstitial pneumonia (UIP): a clinically significant pathologic diagnosis.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Review
- Radiological and Physiological Predictors of IPF Mortality.Medicina (Kaunas, Lithuania) · 2021Article
- COPD, Pulmonary Fibrosis and ILAs in Aging Smokers: The Paradox of Striking Different Responses to the Major Risk Factors.International journal of molecular sciences · 2021Review
- Sex-Specific Clinical Characteristics and Mortality Predictors in Patients With Usual Interstitial Pneumonia Pattern: A Retrospective Cohort Study Highlighting Male Health Risks.American journal of men's healthArticle
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Authors and funding
14 authors.
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Abstract
backgroundAccurate diagnosis of idiopathic pulmonary fibrosis (IPF) is essential to inform prognosis and treatment. In 2018, the ATS/ERS/JRS/ALAT and Fleischner Society released new diagnostic guidelines for usual interstitial pneumonitis (UIP)/IPF, adding Probable UIP as a CT category based on prior studies demonstrating this category had relatively high positive predictive value (PPV) for histopathologic UIP/Probable UIP. This study applies the 2018 ATS/ERS/JRS/ALAT and Fleischner Society guidelines to determine test characteristics of CT categories in academic clinical practice.
methodsCT and histopathology were evaluated by three thoracic radiologists and two thoracic pathologists. Comparison of consensus categorization by the 2018 ATS and Fleischner Society guidelines by CT and histopathology was performed.
resultsOf patients with CT UIP, 87% (PPV, 95% CI: 60-98%) had histopathologic UIP with 97% (CI: 90-100%) specificity. Of patients with CT Probable UIP, 38% (PPV, CI: 14-68%) had histopathologic UIP and 46% (PPV, CI: 19-75%) had either histopathologic UIP or Probable UIP, with 88% (CI: 77-95%) specificity. Patients with CT Indeterminate and Alternative Diagnosis had histopathologic UIP in 27% (PPV, CI: 6-61%) and 21% (PPV, CI: 11-33%) of cases with specificities of 90% (CI: 80-96%) and 25% (CI: 16-37%). Interobserver variability (kappa) between radiologists ranged 0.32-0.81.
conclusionsCT UIP and Probable UIP have high specificity for histopathologic UIP, and CT UIP has high PPV for histopathologic UIP. PPV of CT Probable UIP was 46% for combined histopathologic UIP/Probable UIP. Our results indicate that additional studies are needed to further assess and refine the guideline criteria to improve classification performance.
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