Interstitial lung abnormalities detected incidentally on CT: a Position Paper from the Fleischner Society

Hiroto Hatabu, Gary M. Hunninghake, Luca Richeldi, Kevin K. Brown, Athol U. Wells, Martine Remy-Jardin, Johny Verschakelen, Andrew G. Nicholson, Mary B. Beasley, David C. Christiani, Raúl San José Estépar, Joon Beom Seo, Takeshi Johkoh, Nicola Sverzellati, Christopher J. Ryerson, R. Graham Barr, Jin Mo Goo, John H.M. Austin, Charles A. Powell, Kyung Soo LeeYoshikazu Inoue, David A. Lynch

Research output: Contribution to journalReview articlepeer-review

250 Scopus citations


The term interstitial lung abnormalities refers to specific CT findings that are potentially compatible with interstitial lung disease in patients without clinical suspicion of the disease. Interstitial lung abnormalities are increasingly recognised as a common feature on CT of the lung in older individuals, occurring in 4–9% of smokers and 2–7% of non-smokers. Identification of interstitial lung abnormalities will increase with implementation of lung cancer screening, along with increased use of CT for other diagnostic purposes. These abnormalities are associated with radiological progression, increased mortality, and the risk of complications from medical interventions, such as chemotherapy and surgery. Management requires distinguishing interstitial lung abnormalities that represent clinically significant interstitial lung disease from those that are subclinical. In particular, it is important to identify the subpleural fibrotic subtype, which is more likely to progress and to be associated with mortality. This multidisciplinary Position Paper by the Fleischner Society addresses important issues regarding interstitial lung abnormalities, including standardisation of the definition and terminology; predisposing risk factors; clinical outcomes; options for initial evaluation, monitoring, and management; the role of quantitative evaluation; and future research needs.

Original languageEnglish
Pages (from-to)726-737
Number of pages12
JournalThe Lancet Respiratory Medicine
Issue number7
StatePublished - Jul 2020


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