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Although forced vital capacity is validated for the assessment of idiopathic pulmonary fibrosis (IPF) progression and prediction of mortality, the need for tests that are more sensitive to pathophysiological change in the lungs in IPF is well recognised for earlier diagnosis, longitudinal assessment and for better markers of therapy and prognosis.1
Imaging in IPF in clinical radiological practice currently resides with structural computed tomography. The structural changes seen in IPF on computed tomography are regionally heterogeneous and represent different aspects of the pathology and lung disease evolution.2 Computed tomography is now being used more quantitatively with image segmentation and texture analysis to classify the different structural changes. These algorithms show prognostic promise,3 but it remains to be seen how sensitive they are to disease progression. There is a possibility that manifestation of structural changes on computed tomography is too late …
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