Significance of Using the Interstitial Lung Disease Reporting and Data System (ILD-RADS) in Diagnosis of ILDs

Background: A standardized template for reporting interstitial lung diseases (ILDs) at high-resolution computed tomography (HRCT) called the Interstitial Lung Disease Imaging Reporting and Data System (ILD-RADS) was recently introduced.  
Objective: The aim of the current work was to assess the significance of using the ILD-RADS in the diagnosis as well as categorization of ILDs at HRCT.
Patients and methods: This retrospective cross-sectional study comprised 42 ILDs patients. All patients underwent multi-detector HRCT scans, which were reviewed and categorized according to the ILD-RADS by an experienced radiologist. The final diagnoses of ILDs were determined by multidisciplinary diagnosis with transbronchial lung biopsy (n=4) or without lung biopsy (n=38).
Results: The study included 18 males and 24 females, (with median age 57 years, and interquartile range=52-64 years). Based on the final diagnoses, cases were classified into two groups: cases with idiopathic pulmonary fibrosis (IPF) (n=8) and with non-IPF ILDs (n=38). The most commonly found HRCT pulmonary finding in all patients was pulmonary reticulations (n=42, 100%). The presence of honeycombing was significantly different between patients with IPF and those without IPF. (P=0.02). The detected extra-pulmonary findings did not differ significantly between IPF and non-IPF patients. 87.5% of IPF patients were assigned ILD-‎RADS-1 versus 23.5% of non-IPF patients (P=0.0008). 47.1% of the non-IPF ‎patients were assigned ILD-RADS-4 versus none of the IPF patients (P=0.014).
Conclusion: It could be concluded that using the ILD-RADS can help differentiate between IPF and non-IPF ILDs at HRCT.