A stepwise multi-disciplinary algorithm for diagnosis of fibrosing lung diseases contributing MDCT, MRI, and PET/CT: a study on 250 patients using significance and validation analyses

Background The new guidelines limited the use of lung biopsy in the evaluation of lung fibrosis because of its hazards. The differential diagnosis of interstitial pulmonary fibrosis (IPF) or usual interstitial pneumonia (UIP) is challenging because of overlapping multi-detector computed tomography (MDCT) morphologic features between interstitial and non-interstitial fibrosing lung diseases. Scar carcinoma is a serious complication that needs to be excluded in certain conditions. Aim of the work: To achieve a multi-disciplinary algorithm for the diagnosis of fibrosing lung diseases to limit the need for lung biopsy by combining the clinico-laboratory and radiological roles. Results This study included two major steps. The first step (prevalence/significance analysis of the contributing parameters for the diagnosis of fibrosing lung diseases) was retrospectively conducted on 150 patients pathologically proved with fibrosing lung disease during the period between January/2016 and April/2018. Based on a P-value Conclusions A valid stepwise multi-disciplinary algorithm was proposed for the diagnosis of interstitial and non-interstitial fibrosing lung diseases to limit the need and hazards of lung biopsy. It contributed significant clinico-laboratory data, MDCT features, T2-WI and DWI-MRI findings as well as PET/CT results.