Evaluating the Diagnostic Performance of High-Resolution Computed Tomography in Detecting Idiopathic Pulmonary Fibrosis in Suspected Cases
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Background: High-resolution computed tomography (HRCT) is central to the evaluation of suspected idiopathic pulmonary fibrosis (IPF), particularly through recognition of usual interstitial pneumonia (UIP) patterns. Diagnostic interpretation must nevertheless integrate clinical exclusion of alternative causes and, where appropriate, multidisciplinary assessment. Objective: To evaluate HRCT features associated with a final radiologist classification of IPF in suspected cases. Methods: A cross-sectional study included 68 adults referred for HRCT because of suspected IPF. Ground-glass opacity, honeycombing, reticulation, their distributions, and final radiological diagnosis were recorded. Results: Sixty-two patients (91.2%) received a final HRCT classification of IPF and six (8.8%) another pulmonary diagnosis. Honeycombing was present in 38/68 (55.9%), reticulation in 41/68 (60.3%), and ground-glass opacity in 35/68 (51.5%). All 38 patients with honeycombing were within the final HRCT-IPF group, while 24 additional HRCT-IPF cases had no honeycombing. Against this internal radiological classification, honeycombing showed sensitivity of 61.3% (95% CI 48.8–72.4%), specificity of 100% (95% CI 61.0–100%), positive predictive value of 100% (95% CI 90.8–100%), and negative predictive value of 20.0% (95% CI 9.5–37.3%). Conclusion: Honeycombing, reticulation, and ground-glass opacity were associated with the final radiological classification, but the study does not provide independent diagnostic-accuracy validation because the HRCT features and final diagnosis derive from the same imaging assessment.
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