Session to Investigate Developments Leading to Improved Diagnosis of Lung Disease

State of the Art on Thoracic Imaging and Radiographic Metrics in the Quantification of Lung Disease (C92)

2:15-4:15 p.m.

Marquis Ballroom Salon 6 (Level M2), Marriott Marquis Washington

The role and the utility of thoracic imaging in lung disease are evolving rapidly. From the recent approval of lung cancer screening using CT to advances in the quantification of vascular damage in COPD, imaging is moving to center stage in the evaluation and treatment of lung disease.

“We have created an opportunity for every attendee at the International Conference to learn about the ways thoracic imaging is evolving,” says David Lynch, MD, professor of radiology at National Jewish Health in Denver. “This is intended as a convenient and complete session to help pulmonary physicians in their clinical practice.”

In conjunction with the American College of Radiology, Dr. Lynch helped to organize the Tuesday session in which three presenters will focus on recent changes to clinical imaging and research-related topics.

One of the most important recent changes to thoracic imaging was the acceptance of lung cancer screening by CT as a tool to reduce mortality. CT-based lung cancer screening is now approved for reimbursement by the Centers for Medicare and Medicaid Services and most commercial health insurance plans.

“Lung cancer screening is being implemented by institutions across the country,” Dr. Lynch says. “It is important for thoracic and pulmonary physicians to be involved in those implementation efforts.”

Successful implementation of lung cancer screening requires a team approach, he says. Screening involves communication with the patient before imaging, taking the image, discussing the results with the patient, and following up regarding any abnormal findings.

Lung imaging also is becoming more important in pulmonary fibrosis. Not only is CT imaging for fibrosis improving, the recent approval of two agents for the treatment of idiopathic pulmonary fibrosis emphasizes the need for early and accurate diagnosis.

“We are learning that some of our existing criteria for making the IPF diagnosis require some tweaking,” Dr. Lynch says. “The ATS and other groups are actively working on revising and updating our criteria.”

Pulmonary hypertension is another condition benefiting from advances in imaging. Significant advances in noninvasive assessment using magnetic resonance imaging and evaluation of the right ventricle promise to transform practice.

The research agenda begins with advances in machine learning to improve the speed and accuracy of radiologic evaluation of lung nodules. There are new metrics that use CT imaging to quantify diffuse lung diseases, including COPD and lung fibrosis. It also appears CT imaging can be used to assess pulmonary vascular changes as an early sign of smoking-related lung damage and a predictor of COPD.

“We have an array of exciting advances in imaging that are helping us learn more about how different lung diseases progress,” Dr. Lynch says. “Many ATS members are aware of some of these advances, but this is an opportunity to get up to speed on all of them in a single session.”

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