{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T21:36:50Z","timestamp":1775165810088,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF. Ingrassia\u201d of the University of Catania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study aims to distinguish radiological differences between primary idiopathic Usual Interstitial Pneumonia (UIP) and secondary UIP patterns Methods: This retrospective study included patients with HRCT findings consistent with a UIP pattern. Final diagnoses were established via multidisciplinary discussion and classified as primary UIP\/IPF or secondary UIP, following the 2022 ATS\/ERS\/JRS\/ALAT guidelines. An expert thoracic radiologist (&gt;10 years of experience), blinded to clinical data, reviewed the earliest available HRCT assessing key imaging features: honeycombing (micro-, macro- or exuberant), fibrosis distribution (symmetry, anterior-upper lobe sign, etc.), ground-glass opacities (GGO), dilatation of esophagus. Additionally, AI software AVIEW Build 1.1.46.28-win Coreline (\u00a9Coreline Soft Co., Ltd. All Rights Reserved). performed lung texture analysis, quantifying total lung volume and radiological patterns. Statistical analysis was performed to reveal results. Results: Among 53 cases, 31 were classified as IPF and 22 as secondary UIP cases. The expert radiologist achieved a diagnostic sensitivity of 82.9%, specificity of 889%, with a positive predictive value of 93.5%\u2014in distinguishing between primary and secondary UIP. Primary UIP cases exhibited typical hallmark radiological features, including uniform honeycombing with cranio-caudal distribution (90.3%). Reticulations contributed significantly to the fibrotic texture, maintaining a consistent cranio-caudal gradient and axial symmetry (84.8%). Secondary UIP displayed more significant radiological heterogeneity, including patchy fibrosis with irregular GGO distribution (84.5% versus 53.33%); other findings\u2014such as exuberant honeycombing, four corner sign and wedge-shaped fibrosis\u2014were mainly observed in secondary pattern with respective percentages of 31.8%, 9% and 49%. Conclusions: Experienced thoracic radiologists, leveraging hallmark imaging features, play a critical role in improving diagnostic accuracy between primary and secondary UIP patterns.<\/jats:p>","DOI":"10.3390\/jcm14124162","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T03:59:17Z","timestamp":1749700757000},"page":"4162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Radiological Insights into UIP Pattern: A Comparison Between IPF and Non-IPF Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7196-2974","authenticated-orcid":false,"given":"Stefano","family":"Palmucci","sequence":"first","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Pulmonary Imaging and Advanced Radiological Techniques Unit (UOSD IPTRA), 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Adorna","sequence":"additional","affiliation":[{"name":"Training in Radiology Residency, Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrasia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelica","family":"Rapisarda","sequence":"additional","affiliation":[{"name":"Degree Course of Medicine and Surgery, University of Catania, 95124 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7621-3217","authenticated-orcid":false,"given":"Alessandro","family":"Libra","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4239-8051","authenticated-orcid":false,"given":"Sefora","family":"Fischetti","sequence":"additional","affiliation":[{"name":"Training in Pulmonology, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9933-1202","authenticated-orcid":false,"given":"Gianluca","family":"Sambataro","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Enna \u201cKore\u201d, 94100 Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Letizia Antonella","family":"Mauro","sequence":"additional","affiliation":[{"name":"Pulmonary Imaging and Advanced Radiological Techniques Unit (UOSD IPTRA), 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"David","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Radiology 1 Unit, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0918-0103","authenticated-orcid":false,"given":"Pietro Valerio","family":"Foti","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Radiology 1 Unit, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6303-1998","authenticated-orcid":false,"given":"Claudia","family":"Mattina","sequence":"additional","affiliation":[{"name":"University Hospital Policlinico \u201cG.Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5562-189X","authenticated-orcid":false,"given":"Corrado","family":"Spatola","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Radiotherapy UOSD, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5120-9926","authenticated-orcid":false,"given":"Carlo","family":"Vancheri","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, 95123 Catania, Italy"},{"name":"Regional Referral Center for Rare Lung Disease, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Basile","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Radiology 1 Unit, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4132\/jptm.2023.11.17","article-title":"Diagnosis of interstitial lung diseases: From Averill A. Liebow to artificial intelligence","volume":"58","author":"Yi","year":"2024","journal-title":"J. Pathol. Transl. 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