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Meta-Analysis
. 2025 Jan;35(1):276-288.
doi: 10.1007/s00330-024-10952-9. Epub 2024 Jul 19.

Prevalence and progression rate of interstitial lung abnormalities detected on thoracic CT: a systematic review and meta-analysis

Jisun Hwang  1 , Seulgi You  2 , Ye Jin Lee  3 , Joo Sung Sun  1
Affiliations
Meta-Analysis

Prevalence and progression rate of interstitial lung abnormalities detected on thoracic CT: a systematic review and meta-analysis

Jisun Hwang et al. Eur Radiol. 2025 Jan.

Abstract

Objectives: To estimate the pooled prevalence and progression rate of ILAs and identify the risk factors for radiological progression.

Materials and methods: An EMBASE and PubMed search was undertaken, identifying all studies meeting the inclusion criteria performed before May 10, 2023. Random effect models were used to estimate pooled prevalence, ILA progression rates, and odds ratio for radiological progression based on radiological subtype. Subgroup analyses were performed to compare the general and high-risk populations for lung cancer. The quality of the included studies was evaluated using the risk of bias assessment tool for non-randomized studies.

Results: We analyzed 19 studies (241,541 patients) and 10 studies (1317 patients) for the pooled prevalence and progression rate of ILA, respectively. The pooled ILA prevalence was 9.7% (95% CI, 6.1-13.9%). The pooled prevalence was 6.8% (95% CI, 3.1-11.6%) and 7.1% (95% CI, 2.2-14.4%) in the general (six studies) and high-risk population for lung cancer (six studies), respectively. The pooled progression rate was 47.1% (95% CI, 29.1-65.5%). The pooled progression rate was 64.2% (95% CI, 45.0-81.2%, five studies) and 31.0% (95% CI, 8.2-60.5%, five studies) for longer (≥ 4.5 years) and shorter follow-up periods (< 4.5 years), respectively (p = 0.009). Fibrotic ILAs were significantly associated with a higher progression probability (combined OR, 5.55; 95% CI, 1.95-15.82).

Conclusions: The prevalence of ILAs was approximately 9.7%. Approximately half of the patients exhibited radiological progression, with the rate increasing over a longer follow-up period. Fibrotic ILA was a significant risk factor for radiological progression.

Clinical relevance statement: The prevalence of interstitial lung abnormalities (ILAs) is approximately 9.7%, with about half exhibiting progression; a longer follow-up duration and fibrotic ILAs are associated with a higher progression rate.

Key points: ILAs are increasingly recognized as important, but few population data are available. ILAs exhibited a pooled prevalence of 9.7% with a progression rate of 47.1%. Fibrotic ILAs were associated with increased progression likelihood.

Keywords: Disease progression; Lung diseases (interstitial); Prevalence; Tomography (x-ray computed).

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Conflict of interest statement

Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Seulgi You. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: Ji Sung Lee, PhD (Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea) kindly provided statistical advice for this manuscript. Informed consent: Written informed consent was not required for this study because this was a systematic review and meta-analysis. Ethical Approval: Institutional Review Board approval was not required because this was a systematic review and meta-analysis. Study subjects or cohorts overlap: Some study subjects or cohorts have been previously reported in the studies that were included in the systematic review and meta-analysis. Methodology: Retrospective Systematic review Meta-analysis

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