High-resolution CT: Can it obviate lung biopsy?

The increasing use of high-resolution CT (HRCT) should lead to a reconsideration of the traditional manner in which patients with diffuse interstitial lung disease are evaluated. HRCT is no longer used only in the assessment of rare diseases or exclusively in academic medical centers. There are many clinically important uses of HRCT in patients with pulmonary symptoms; in some cases, the imaging findings are diagnostic and obviate tissue diagnosis. The frequency with which this occurs depends on the type and stage of disease present and on the skill and confidence of the individual interpreting the images Accurate HRCT interpretation also requires correlation with clinical information. The diagnostic evaluation of patients with known or suspected lung disease should involve pulmonologists, thoracic radiologists, and thoracic surgeons.