Interstitial lung abnormalities (ILAs) are abnormalities identified on computed tomography (CT) that are potentially compatible with interstitial lung disease (ILD) in patients without clinical suspicion for ILD. Per the 2020 Fleischner Society Position Paper, ILAs are purely an imaging finding and diagnosis does not necessitate the absence of respiratory symptoms or pulmonary function impairment; however, when these features are present, a diagnosis of ILD should be considered.1 Adherence to this recommendation is critical for improving early identification of ILD but is challenged by the lack of expert-based consensus criteria differentiating ILAs from ILD. Further complicating this issue, ILAs are often unrecognized and underreported by radiologists and infrequently prompt pulmonary referral for evaluation of possible ILD.2 Additionally, existing ILD clinics with associated multidisciplinary discussions may not have the time or expertise to systemically evaluate and longitudinally follow each patient with ILAs and discuss their imaging findings in detail. Creating the infrastructure to support increased recognition and timely referral of ILAs could be key to improving outcomes within ILD.

Our objective was to establish an ILA clinic and multidisciplinary discussion to (1) identify and characterize ILAs, (2) identify modifiable factors associated with development of ILD, and (3) tailor follow-up testing based on perceived risk of ILA progression.

We established a biweekly ILA clinic and monthly multidisciplinary discussion in July 2022 at the University of Chicago Medicine and report the first year of findings. Our study was formally reviewed and determined to be quality improvement; therefore, institutional review board review was not required and informed consent was waived, per institutional policy.

A total of 20 clinic sessions were held over the course of the year. Referrals were solicited through correspondence and educational presentations to departments and divisions where providers were likely to order CT scans …

Correspondence: Kavitha Selvan MD, 5841 S Maryland Avenue, Chicago, IL 60637. E-mail: kavitha.selvanuchicagomedicine.org