Imaging and molecular biomarkers: a novel approach to screen populations at risk of pulmonary fibrosis?

An estimated 90 million subjects in the USA have a history of smoking, and are therefore at risk of developing smoke-related lung diseases including lung cancer, chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. An ageing population, the lack of effective diagnostic and therapeutic approaches, and the modest impact of smoking cessation strategies largely explain why chronic lower respiratory diseases are presently a leading cause of death in the US adult population [1]. In 2014, a US National Heart, Lung and Blood Institute task force concluded that effective primary and secondary prevention of chronic lung diseases will require focused efforts to determine risk factors and characterise early-stage disease in at-risk groups. Additionally, development of surrogate measures such as imaging and molecular biomarkers are required to support the design of randomised clinical trials to test chronic lung disease preventive strategies [2].