The Pulmonary Fibrosis Foundation (PFF) has issued a position statement that serves as a guide for conducting high-resolution computed tomography (HRCT) of the thorax for interstitial lung disease (ILD). The statement highlights important patterns seen in idiopathic pulmonary fibrosis, features that differentiate different types of fibrotic lung diseases, and a standardized format for reporting results. 

“It is essential that pulmonologists utilize the most sensitive imaging protocol for diagnosing ILD, which is often misdiagnosed due to its symptomatic similarity with other diseases,” said Dr. Gregory Cosgrove, chief medical officer for the PFF. “Following the PFF Radiology working groups’ recommendations, the HRCT protocol of the thorax can help clinicians determine a clear, minimally-invasive diagnosis more effectively.”

The statement outlines the protocol for conducting HRCT of the thorax for ILD in three series: (1) supine, inspiration (2) supine, expiration and, if a dependent density is noted, (3) prone, inspiration. Each series details breathing instructions, scout view, scan range and parameters for expiratory CT acquisition and image reconstruction.

In the statement, the PFF recommends that HRCT technologists should review scans immediately after acquisition and repeat as appropriate if there is motion artifact or inadequate inspiration (in clearly non-diagnostic cases), or contact a radiologist immediately while the patient is on the scanner gantry to determine whether repeating or adding any additional scans is necessary.

The PFF’s full statement containing a comprehensive list of HRCT testing protocol is available here.