Radiology Working Group

You may download the HRCT template protocol here (PDF).

Draft Guidelines for Imaging Fibrotic ILD

Working Group Chair(s): Jonathan Chung, MD, David Lynch, MD

PFF Care Center Network: Recommendations for HRCT Technique

Coach to full inspiration

  • Emphasize importance of holding breath
  • Repeat scans with motion

Volumetric acquisition

Thin section (1-1.5 mm)

Moderate edge-enhancing reconstruction algorithm (e.g. Siemens B45f, GE Bone, Philips D or YB, Toshiba Lung Std.)

Field of view to include only lungs

Coronal and sagittal reconstructions

Routine expiratory CT (contiguous or noncontiguous)

Routine prone CT (noncontiguous)


HRCT report should contain the following

Clinical information


Exam quality

Fibrotic abnormalities

  • Axial and craniocaudal distribution
  • Presence/Absence of
    • Reticular abnormality
    • Traction bronchiectasis
    • Honeycombing
Non-fibrotic Abnormalities
  • Presence/Absence of
  • Groundglass opacity
  • Mosaic attenuation
  • Air-trapping
  • Nodules/Cysts/Consolidation
  • Emphysema

Ancillary findings

  • Lymph node enlargement (often reactive)
  • Pulmonary arterial enlargement
  • Pleural abnormality
  • Lung nodules, etc.


  • Radiologic pattern diagnosis
  • Differential diagnosis
  • Level of confidence
  • Change since prior imaging
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