Today, I review, link to, and excerpt from COREIM‘s ILD and High-Risk Medication Prescribing: Gray Matters Segment.
All that follows is from the above resource.
Posted: February 5, 2025
By: Dr. Alison Trainor, Dr. Kelly Graham, Dr. Rob Hallowell, Jason Krastein and Dr. Jason Freed
Graphic: Dr. Jesse Powell
Audio: Jerome Reyes
Peer Review: Dr. Armand M. Gottlieb, Dr. Robert Koichiro AraoPodcast: Play in new window | Download
Time Stamps
- 01:30 Deep Dive 1: Evaluating Incidental Findings
- 06:45 Deep Dive 2: Categorizing ILD
- 12:42 Deep Dive 3: Treatment for ILD
- 21:19 Deep Dive 4: Addressing Barriers to Care
- 28:10 Deep Dive 5: Ethical Considerations in ILD Treatment
Show Notes
Deep Dive 1: Evaluating Incidental Findings
Why do incidental CT findings matter?
- Subtle interstitial changes on a CT scan may indicate early fibrosis, atelectasis, aspiration, pulmonary edema, or infection. (Though not exhaustive list)
- What is ILD protocol CT?
- High-resolution CT (HRCT) with inspiratory, expiratory, supine and prone images
- Differentiate fibrosis from mimics
- Involves:
- Number of Acquisitions:
- Supine Position: Inspiratory (volumetric) and expiratory (sequential or volumetric) acquisitions.
- Prone Position (Optional): Only inspiratory scans, which can be sequential or volumetric.
- Inspiratory scans should be obtained at full inspiration.
If fibrosis is suspected:
- Refer to pulmonology within 6 months
- Order pulmonary function tests (PFTs) to expedite evaluation.
- PFTs provide data on disease progression and urgency of intervention.
