{"doi":"10.21203/rs.3.rs-45334/v1","title":"Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography","abstract":"<title>Abstract</title>\n        <p><bold>Background:</bold> Usual interstitial pneumonia (UIP) can present with a probable pattern on high-resolution computed tomography (HRCT), but the probability of UIP by surgical lung biopsy in such cases remains controversial. We aimed to determine the final clinical diagnosis in patients with a probable UIP pattern on HRCT subjected to surgical lung biopsy.<bold>Methods: </bold>HRCT images were assessed and categorized by three radiologists, and tissue slides were evaluated by two pathologists, all of whom were blinded to the clinical findings. The final clinical diagnosis was accomplished via a multidisciplinary discussion. Patients with a single layer of honeycombing located outside of the lower lobes on HRCT were not excluded.<bold>Results: </bold>A total of<bold> </bold>50 patients were evaluated. The most common final clinical diagnosis was fibrotic hypersensitivity pneumonitis (38.0%; 95% CI: 24.7% to 52.8%), followed by idiopathic pulmonary fibrosis (24.0%; 95% CI: 13.1% to 38.2%) and interstitial lung disease ascribed to gastroesophageal reflux disease (12.0%; 95% CI: 4.5% to 24.3%) and familial interstitial lung disease (10.0%; 95% CI: 3.3% to 21.8%). In the group without environmental exposure (n = 22), 10 patients had a final clinical diagnosis of idiopathic pulmonary fibrosis (45.5%; 95% CI: 24.4% to 67.8%). Irrespective of the final clinical diagnosis, by multivariate Cox analysis, patients with honeycombing, dyspnoea and the presence of fibroblastic foci on surgical lung biopsy had a high risk of death.<bold>Conclusions: </bold>The most common disease associated with a probable UIP pattern on HRCT is fibrotic hypersensitivity pneumonitis, followed by idiopathic pulmonary fibrosis and interstitial lung disease ascribed to gastroesophageal reflux disease. In patients without environmental exposure, the frequency of UIP and a final clinical diagnosis of idiopathic pulmonary fibrosis are not sufficiently high to obviate the indication for surgical lung biopsy.</p>","journal":"Research Square","year":null,"id":22152,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":140248,"name":"Maria Raquel Soares","orcid":null,"position":1,"is_corresponding":false},{"id":140250,"name":"Karin Mueller Storrer","orcid":null,"position":2,"is_corresponding":false},{"id":140251,"name":"Gustavo de Souza Portes Meirelles","orcid":null,"position":3,"is_corresponding":false},{"id":140252,"name":"Katia Nishiyama","orcid":null,"position":4,"is_corresponding":false},{"id":140253,"name":"Israel Missrie","orcid":null,"position":5,"is_corresponding":false},{"id":140254,"name":"Ester Nei Aparecida Martins Coletta","orcid":null,"position":6,"is_corresponding":false},{"id":140255,"name":"Rimarcs Gomes Ferreira","orcid":null,"position":7,"is_corresponding":false},{"id":140256,"name":"Carlos Alberto de Castro Pereira","orcid":null,"position":8,"is_corresponding":false},{"id":140246,"name":"Regina Tibana","orcid":"0000-0002-9410-8455","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36284789","pmcid":null,"openalex_id":"https://openalex.org/W4251630327","authors":[],"funders":[{"funder_name":"National Centre for the Replacement, Refinement and Reduction of Animals in Research","grant_id":"NC/P001076/1","title":null},{"funder_name":"Biotechnology and Biological Sciences Research Council","grant_id":"BBS/E/T/000PR9817","title":null},{"funder_name":"Wellcome Trust","grant_id":"209558/Z/17/Z","title":null},{"funder_name":"HCRW_","grant_id":"RFPPB-18-1497(T)","title":null},{"funder_name":"Medical Research Council","grant_id":"MR/S036954/1","title":null},{"funder_name":"Medical Research Council","grant_id":"MR/K010468/1","title":null}],"total_grants":6,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"green","license":"cc-by","oa_locations":[{"url":"https://www.researchsquare.com/article/rs-45334/v1.pdf?c=1595635971000","host_type":"repository"},{"url":"https://www.researchsquare.com/article/rs-45334/v1.pdf?c=1595635971000","host_type":"repository"},{"url":"https://www.researchsquare.com/article/rs-45334/v1","host_type":"publisher"},{"url":"https://www.researchsquare.com/article/rs-45334/v1.html","host_type":"publisher"},{"url":"https://doi.org/10.21203/rs.3.rs-45334/v1","host_type":"repository"}],"fields_of_study":["Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis","Sarcoidosis and Beryllium Toxicity Research","Medical Imaging and Pathology Studies"],"mesh_terms":[],"keywords":["Usual interstitial pneumonia","High-resolution computed tomography","Computed tomography","Radiology","Medicine","Lung biopsy","Lung","Pneumonia","High resolution","Resolution (logic)","Biopsy","Interstitial pneumonia","Internal medicine","Computer science","Geology","Artificial intelligence","carotid-cavernous fistula","endoscopy","endovascular treatment","transsphenoidal surgery","video"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-06-06T18:05:33.112960Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}