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. 2020 Jan 6;21:7. doi: 10.1186/s12931-019-1269-6

Table 1.

Summary of studies contributing to change in IPF diagnostic guidelines

Study author, reference Patient subgroup HRCT results SLB results Diagnosis by 2011 guidelines [14] Notes
Cohort study involving 201 patients with pulmonary fibrosis who underwent lung biopsy within 1 year of chest CT scan
Chung [24] Probable UIP* Reticulation, little or no honeycombing Definite*/probable* UIP 82% IPF Probable UIP* by HRCT was more likely to have UIP confirmed by SLB than indeterminate UIP* by HRCT
Indeterminate*18% Probable IPF
Indeterminate for UIP* Indeterminate Definite*/probable* UIP 54% IPF
Indeterminate*46% Probable IPF
Post-hoc analysis of pooled data from the INPULSIS trials on 1061 patients with honeycombing and/or diagnosis of UIP by SLB
Raghu [25] Honeycombing or SLB Honeycombing Not specified IPF Disease progression & response to nintedanib similar between groups
Not specified UIP
No honeycombing or SLB Features of possible UIP and traction bronchiectasis, no honeycombing None available SLB required

*Definite UIP: peripheral and basilar predominant pulmonary fibrosis characterized by reticulation, honeycombing, and absence of findings to suggest another specific diagnosis; probable UIP: peripheral and basilar predominant pulmonary fibrosis with reticulation, little/no honeycombing but with otherwise typical features of UIP; indeterminate UIP: pulmonary fibrosis with imaging findings not sufficient to reach a definite, probable, or inconsistent with UIP diagnosis [24]

CT Computed tomography, HRCT High-resolution computed tomography, IPF Idiopathic pulmonary fibrosis, SLB Surgical lung biopsy, UIP Usual interstitial pneumonia