Idiopathic pulmonary fibrosis

Preliminary Diagnosis: Idiopathic Pulmonary Fibrosis

I. What imaging technique is first-line for this diagnosis

• Chest x-ray, PA and lateral view

II. Describe the advantages and disadvantages of this technique for diagnosis

Advantages

• Highly portable and relatively inexpensive imaging modality

• Exposes patients to minimal ionizing radiation

Disadvantages

• Less sensitive and specific in diagnosing a primary parenchymal and/or pleural abnormality or detecting any secondary complications compared to cross-sectional imaging

• Unable to evaluate the secondary pulmonary lobule, which would be helpful in generating a differential diagnosis

III. What are the contraindications for the first-line imaging technique?

• No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.

IV. What alternative imaging techniques are available?

• CT of the chest without contrast/high resolution CT of the chest

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis

CT of the chest without contrast/high resolution CT of the chest

Advantages

• The gold standard in evaluating and characterizing idiopathic pulmonary fibrosis

• Highly sensitive and specific in evaluating for a primary parenchymal and/or pleural abnormality, and detailing and characterizing a secondary complication

• Offers exquisite visualization and evaluation of the secondary pulmonary lobule and interlobular and intralobular septae.

Disadvantages

• Exposes patients to ionizing radiation

• More expensive compared to plain radiography

VI. What are the contraindications for the alternative imaging techniques?

CT of the chest without contrast/high resolution CT of the chest

• CT imaging may be contraindicated in pregnant patients.