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Two chest radiologists independently reviewed whole-lung high-resolution CT (HRCT) images, with the other two radiologists evaluating biopsy sites. Faint amorphous nodular opacity (FANO) was defined as a small, faint nodular opacity superimposed on amorphous ground-glass opacity (GGO) within 1\u00a0cm of the pleural surface, showing a band-like distribution parallel to the pleura. Three pulmonary pathologists performed histological evaluation. Discrepancies were resolved through consensus, with CT-pathologic correlation established through joint radiologist-pathologist review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-eight patients (mean age, 57\u00a0years\u2009\u00b1\u200910; 15 men) were evaluated with 79 biopsy specimens. Nonspecific interstitial pneumonia was the predominant pattern on whole-lung HRCT (21 patients, 75%) and pathology (17 patients, 61%). At biopsy sites, GGO was most frequent (92%), followed by reticulation (84%). Reticulation was accompanied by GGO in nearly all cases, reflecting underlying diffuse fibrotic changes. Reticulation patterns with or without traction bronchiolectasis corresponded to varying fibrosis types, spatial distribution, and architectural destruction severity. Specifically, irregular reticulation with traction bronchiolectasis indicated dense fibrosis with severe destruction, representing UIP-like features. FANO was observed in 18 patients (64%), predominantly in anterolateral upper lobes, and corresponded pathologically to perivenular fibrosis and peribronchiolar metaplasia with or without mucostasis. Longitudinal evaluation (median 32.5\u00a0months) in 14 patients showed progression in 71%; half of these showed coalescence into subpleural curvilinear opacities with reticulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SSc-ILD demonstrates predominantly diffuse fibrotic changes. Irregular reticulation with traction bronchiolectasis indicates UIP-like features, potentially identifying patients at risk for progression. FANO, observed most commonly in anterolateral upper lobes, frequently progresses to reticulation on longitudinal follow-up, suggesting potential value for early-stage detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Secondary abstract<\/jats:title>\n                    <jats:p>SSc-ILD demonstrated diffuse fibrotic changes as a characteristic feature, while irregular reticulation with traction bronchiolectasis indicated UIP-like fibrosis with severe architectural destruction. FANO, a newly described finding observed in 64% of cases, was predominantly in anterolateral upper lobes and corresponded to perivenular fibrosis and peribronchiolar metaplasia, representing potential early-stage changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11604-025-01922-2","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T03:02:47Z","timestamp":1766026967000},"page":"673-684","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comprehensive radiologic-pathologic correlation in systemic sclerosis-associated interstitial lung disease: identification of an early-stage CT findings"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9173-738X","authenticated-orcid":false,"given":"Taiki","family":"Fukuda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Yamano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoko","family":"Egashira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Sumikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikiko","family":"Hashisako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Tominaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Matsumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Ueno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusei","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroya","family":"Ojiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Hatabu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reoto","family":"Takei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Kataoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Kondoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Fukuoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Johkoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Collaboration Project of Radiology and Pathology in Diffuse Lung Diseases Research Group of the Ministry of Health, Labor and Welfare, Japan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosaku","family":"Komiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Shimamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Tateishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriko","family":"Yoshidome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"issue":"19","key":"1922_CR1","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1056\/NEJMra0806188","volume":"360","author":"A Gabrielli","year":"2009","unstructured":"Gabrielli A, Avvedimento EV, Krieg T. 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This support was not specific to the present work. Y.Y. reports lecture fees from Boehringer Ingelheim, Japan, Inc., and Chugai Pharmaceutical Co., Ltd. R.E. reports lecture fees from Boehringer Ingelheim, Japan, GE HealthCare Pharma. KYORIN Pharmaceutical Co., Ltd., Shionogi & Co., Ltd., and reports receiving support for attending meetings from Boehringer Ingelheim, Japan. H.S. reports lecture fees and reports receiving support for attending meetings from Boehringer Ingelheim, Japan. D.Y. reports research grant fees from Astellas Pharma Inc., Bayer Yakuhin, Ltd. Academic Support, St. Luke\u2019s Health Science Research, and St. Luke\u2019s Breast Cancer Charity Fund. H.H. is supported by grants NIH\/NCI R01CA203636, NIH\/NCI U01CA209414, NIH\/NHLBI R01HL111024, NIH\/NHLBI R01HL135142, and NIH\/NHLBI R01HL130974, and has the provisional US patent application with the serial number 63\/610,842. Brigham and Women\u2019s Hospital is funded with a research grant from Canon Medical Systems Corporation. K.K. reports lecture fees from Nippon Boehringer Ingelheim Co., Ltd. T.K. reports lecture fees from AstraZeneca K.K., Sanofi K.K., Eli Lilly Japan K.K, Boehringer Ingelheim, Chugai Pharmaceutical Co., Ltd., GlaxoSmithKline plc, KYORIN Pharmaceutical Co, Ltd, MSD K.K., Mochida Pharmaceutical Co., LTD., Takeda Pharmaceutical Co, Ltd, Novartis Pharma KK, Insmed Incorporated. Y.Kondoh. reports consulting fees from Asahi Kasei Pharma Corp, Boehringer Ingelheim, Chugai Pharmaceutical Co., Ltd., GlaxoSmithKline plc, Healios K.K., Janssen Pharmaceutical K.K., Mochida Pharmaceutical Co., LTD, Shionogi Co, Ltd., Taiho Pharmaceutical Co., and lecture fees from Asahi Kasei Pharma Corp, Bristol Myers Squibb, Boehringer Ingelheim, Eisai Co, Ltd, Janssen Pharmaceutical K.K., GlaxoSmithKline plc, KYORIN Pharmaceutical Co, Ltd, Mitsubishi Tanabe Pharma, Nippon Shinyaku Co., Ltd, Novartis Pharma K.K., Shionogi Co, Ltd., Teijin Pharma Ltd. J.F. reports lecture fees from Boehringer Ingelheim. T.J. reports lecture fees from AstraZeneca, Boehringer Ingelheim, KYORIN Pharmaceutical Co, Ltd. The remaining authors have no relevant disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in accordance with the Declaration of Helsinki. This human study was approved by The Jikei University School of Medicine\u2014approval: 34-142(11293). Adult participant consent was not required because the requirement for written informed consent was waived due to the retrospective nature of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Adult participant consent was not required because the requirement for written informed consent was waived due to the retrospective nature of the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}