Advancing the Early Diagnosis of Interstitial Lung Diseases – Beyond ILAs

Interstitial lung abnormalities (ILAs) are increasingly recognised due to the widespread use of low-dose computed tomography (LDCT) in lung cancer screening programs. ILAs are incidental radiological findings that may represent early stages of interstitial lung disease (ILD). Their presence has been associated with an increased risk of progression to clinically significant ILD, highlighting the need for early detection and intervention. However, current definitions, such as those provided by the Fleischner Society, rely solely on radiologic criteria and do not fully reflect real-world clinical presentations or disease evolution. The lack of standardised criteria for follow-up and management leaves both clinicians and patients facing uncertainty, necessitating further research to bridge these gaps.

Early diagnosis of ILD is a rapidly growing field, as a timely intervention may improve long-term outcomes and potentially alter disease trajectories. The identification of ILAs in lung cancer screening cohorts has led to a surge of interest in refining diagnostic strategies, developing predictive biomarkers, and assessing the feasibility of screening programs for at-risk populations. However, key questions remain unanswered: who should be screened, how frequently, and what interventions are most appropriate at the earliest stages? Addressing these uncertainties requires a multidisciplinary approach that integrates insights from radiology, genetics, biomarkers, pathology, and patient-centered research.

This research topic aims to bring together leading experts to explore the significance of ILAs, improve diagnostic and screening strategies, and develop evidence-based management approaches. This collection of articles will examine various aspects of early ILD detection, including:

• The role of lung cancer screening programs as early detection tools for ILD.

• Genetic factors influencing early ILD.

• Screening and genetic considerations in familial ILD.

• The potential of cryobiopsy and transcriptomic data in early diagnosis.

• Screening in systemic autoimmune rheumatic diseases (SARD).

• Metabolomics and translational medicine approaches.

• Advances in radiological assessment of ILAs.

• Proteomics research and its implications for ILD.

• Best management strategies for ILAs.

• Patient perspectives on ILD screening programs.

• Considerations on whether and when to initiate treatment in early ILD.

This research collection will provide an in-depth examination of ILAs and early ILD, aiming to standardise diagnostic criteria, refine screening strategies, and improve patient care. By gathering insights from international experts, this research topic for Frontiers will foster collaboration and drive advancements in early ILD diagnosis and management, ultimately benefiting both clinical practice and patient outcomes.

Topic Editor Sara Tommasetti has received speaker's fees from ERBE and Boehringer Ingelheim, an unconditional research grant from AstraZeneca, and consultancy fees from Boehringer Ingelheim. The other Topic Editors declare no conflicts of interest.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Methods
• Mini Review
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review

Keywords: ILA, ILD, Genetic, Diagnosis, Treatment, Anti-Fibrotic, HRCT, Cryobiopsy

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.