Expert comments

Comments on this technology were invited from clinical experts working in the field. The comments received are individual opinions and do not represent NICE's view.

All of the experts were familiar with this technology, but only 1 had used it before.

Level of innovation

All the experts agreed that lung texture analysis is a novel technology for the assessment of interstitial lung diseases and it would be used as well as current radiologist assessment of CT imaging, which is subject to errors of interpretation. There is a lack of appropriately trained thoracic radiologists within the NHS, while a general radiologist can often misread CT images and incorrectly label lung features which leads to misdiagnosis. Therefore, the technology would add value for general radiologists in non-specialist centres. Another expert commented that the technology is most likely to provide utility in specialist centres for people with interstitial lung disease and that it is unlikely for general respiratory clinicians to be employing this type of technology.

Potential patient impact

Three of the 4 clinical experts commented that the technology may help to standardise the level of reporting through objective quantification of CT scans in people with interstitial lung disease. This will allow better identification of people who are showing disease progression and track changes over time in a more reproducible manner than current standard practice. The improved accuracy of diagnosis and reduction in individual variation between CT reporting could provide huge benefits for people. One of the experts explained how improved diagnostic accuracy would allow earlier treatment, potentially improving quality of life and survival in people with interstitial lung disease.

Potential system impact

Three experts commented on the improved accuracy of diagnosis, making sure people have the right treatments at the right time, which would speed up treatment pathways and reduce wastage of inappropriate treatments. The benefit to individual people of a more efficient treatment pathway would reduce both the cost and burden of treatment across the healthcare system. Two of the experts suggested that the technology would be useful in clinical trials where accurate quantification of interstitial lung disease is needed to identify novel treatments for diseases such as idiopathic pulmonary fibrosis. The technology can provide a biomarker of disease phenotype that can be used in the context of a clinical trial.

General comments

All of the experts anticipated that the technology will cost more than current standard care, though 2 experts explained that routine use of the technology might lead to productivity benefits by reducing radiologists' reporting time. All of the experts highlighted that potential users of the technology will need training to interpret the quantified data. None of the experts listed any adverse events or potential risks associated with the technology if the automated CT analysis is reviewed by a radiologist. Two of the experts suggested that real-world NHS experience of the technology is lacking and that it has not really been validated as a tool to be used in clinical practice. This could be overcome by a larger pilot study in a specialist interstitial lung disease centre to show value.