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While idiopathic pulmonary fibrosis (IPF), the most common type of ILD, is the prototype of progressive fibrosis, other forms, collectively termed \u201cprogressive pulmonary fibrosis\u201d (PPF), can show a similar clinical course. Detecting chronic fibrosing ILD progression necessitates radiological evidence using high-resolution computed tomography (HRCT), which determines eligibility for treatment. However, assessing the extent of fibrosis and progression on HRCT images is difficult and lacks specific guidelines. Therefore, expert oversight and high-quality visual assessment\/scoring of complex disease patterns is essential to monitor disease changes. Twelve Italian chest radiologists deliberated on the current state of quantifying lung fibrosis using existing literature to develop practice-oriented consensus statements to assist radiologists in visually assessing\/scoring lung fibrosis on HRCT images in patients with PPF. The resulting statements cover three key areas: (1) technical requirements necessary for accurate HRCT image assessment; (2) an easy-to-use quantification protocol for routine clinical practice; and (3) a multiple specialist approach by combining radiological, clinical, and histopathological findings for the correct diagnosis, prompt detection of PPF, and timely start of antifibrotic treatment. In future, automated quantitative HRCT evaluation will lead to new clinical assessment tools.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s11547-025-01985-1","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T03:48:52Z","timestamp":1743997732000},"page":"965-977","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Quantification of progressive pulmonary fibrosis by visual scoring of HRCT images: recommendations from Italian chest radiology experts"],"prefix":"10.1007","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1061-9507","authenticated-orcid":false,"given":"Elisa","family":"Baratella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4761-2923","authenticated-orcid":false,"given":"Andrea","family":"Borghesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0280-7348","authenticated-orcid":false,"given":"Lucio","family":"Calandriello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-200X","authenticated-orcid":false,"given":"Giancarlo","family":"Cortese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-4591","authenticated-orcid":false,"given":"Giovanni","family":"Della Casa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0924-5883","authenticated-orcid":false,"given":"Chiara","family":"Giraudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2113-7300","authenticated-orcid":false,"given":"Emanuele","family":"Grassedonio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-6244","authenticated-orcid":false,"given":"Anna Rita","family":"Larici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7196-2974","authenticated-orcid":false,"given":"Stefano","family":"Palmucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3023-8784","authenticated-orcid":false,"given":"Chiara","family":"Romei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2997-9181","authenticated-orcid":false,"given":"Ubaldo Romeo","family":"Plastina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-3785","authenticated-orcid":false,"given":"Nicola","family":"Sverzellati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"issue":"1","key":"1985_CR1","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/s12931-021-01879-6","volume":"22","author":"BS Kwon","year":"2021","unstructured":"Kwon BS, Choe J, Chae EJ, Hwang HS, Kim YG, Song JW (2021) Progressive fibrosing interstitial lung disease: prevalence and clinical outcome. 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They did not receive any payment related to the development of the subject manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors declarations"}},{"value":"EB has received fees for participation to top seminars and expert panel from Boheringer Ingelheim. AB is an editor of La Radiologia Medica Journal. He has received fees for participation to top seminars and expert panel from Boheringer Ingelheim. LC has received fees for participation to top seminars and expert panel from Boheringer Ingelheim. GC has received fees for lectures, presentations, and educational events from Boheringer Ingelheim. GDC has no competing interest to declare. CG has received fees for lectures, presentations, and educational events from Boheringer Ingelheim. EG has no competing interest to declare. ARL has received honoraria for consultancies from Boehringer Ingelheim and Astra Zeneca. SP reports personal consulting fees and\/or speaker fees from Boehringer Ingelheim, F. Hoffmann-La Roche Ltd., Elma Research srl, Metanoic Health Limited and DOT tech srl outside the submitted work; he also received support for attending meetings and\/or travel by Bracco Imaging spa, Bayer Schering, Eclat srl and Fondazione Menarini, not related with this submitted work. CR has received fees for participation to top seminars and expert panel from Boheringer Ingelheim. URP has received honoraria for consultancies from Boehringer Ingelheim. NS has received fees for participation to top seminars and expert panel from Boheringer Ingelheim.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study did not require ethics approval or consent because it did not involve human participants, human data, or human tissue.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate or publish"}},{"value":"All authors consent to publish this article in this form.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}