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Diagnostics
Special Issues
Diagnosis and Prognosis of Pulmonary Diseases
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Diagnosis and Prognosis of Pulmonary Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 2761

Editors

Dr. Fabio Perrotta

E-Mail Website
Guest Editor
Department of Translational Medical Sciences, University of Campania “L.Vanvitelli”, 80131 Naples, Italy
Interests: interstitial lung disease; pulmonology; airway obstruction; pulmonary medicine; respiration disorders; chronic obstructive pulmonary disease; biologics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Filippo Scialò

E-Mail Website
Guest Editor
Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
Interests: immunotherapy; lung cancer; mitochondria; reactive oxygen and nitrogen species; immuno-checkpoint inhibitors

Special Issue Information

Dear Colleagues,

This Special Issue invites original research articles and comprehensive reviews focused on improving the diagnosis and prognostic evaluation of major pulmonary diseases, including chronic obstructive pulmonary disease (COPD), asthma, interstitial lung diseases and lung cancer. The aim of this issue is to highlight novel techniques and innovative methodologies that enhance early detection, disease phenotyping, risk stratification and outcome prediction across the spectrum of respiratory disorders.

We particularly welcome contributions employing advanced imaging, molecular and circulating biomarkers, omics approaches, artificial intelligence, machine learning and integrative clinical models, as well as translational and real-world studies with direct clinical relevance. By bringing together cutting-edge methodological advances and disease-specific applications, this Special Issue seeks to foster precision medicine approaches and improve patient management and prognosis in pulmonary diseases.

Dr. Fabio Perrotta
Prof. Dr. Filippo Scialò
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • interstitial lung disease
  • pulmonology
  • airway obstruction
  • pulmonary medicine
  • respiration disorders

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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12 pages, 563 KB  
Article
Role of Airwave Oscillometry in Patients with Combined Fibrosis–Emphysema Syndrome (CPFE) with Preserved FEV1/FVC Ratio
by Raffaella Pagliaro, Filippo Scialò, Domenica Francesca Mariniello, Vito D’Agnano, Maria Ilaria Palma, Susan F. Campbell, Josuel Ora, Francesco Saverio Cerqua, Giulia Maria Stella, Andrea Bianco and Fabio Perrotta
Diagnostics 2026, 16(8), 1159; https://doi.org/10.3390/diagnostics16081159 - 14 Apr 2026
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Abstract
Introduction: Emphysema is frequently observed in patients with fibrosing interstitial lung diseases (f-ILDs), leading to the clinical entity known as combined pulmonary fibrosis and emphysema (CPFE). This study aimed to evaluate the utility of airwave oscillometry (AOS) in detecting small-airway dysfunction (SAD) in [...] Read more.
Introduction: Emphysema is frequently observed in patients with fibrosing interstitial lung diseases (f-ILDs), leading to the clinical entity known as combined pulmonary fibrosis and emphysema (CPFE). This study aimed to evaluate the utility of airwave oscillometry (AOS) in detecting small-airway dysfunction (SAD) in patients with CPFE. Due to the coexistence of both restrictive and obstructive airway disease, spirometry is comparatively less sensitive in detecting airflow limitations in this population. Methods: A cohort of 52 patients with CPFE was recruited from Monaldi Hospital, Naples, between January and September 2023. Pulmonary function tests—including spirometry, body plethysmography, and single-breath diffusing capacity for carbon monoxide (DLCO)—were performed at baseline and following bronchodilator administration. Patients with normal FEV1/FVC ratios underwent airwave oscillometry (AOS) to assess respiratory system resistance (Rrs) and reactance (Xrs), with SAD defined as an R5–R19 value greater than 0.07 kPa·s·L−1. Results: AOS-defined SAD was present in 40.4% (21/52) of the cohort. The R5–R19 value in the SAD group was 0.13 ± 0.05 kPa·s·L−1, which can be compared to 0.04 ± 0.02 kPa·s·L−1 in patients without SAD. Patients with SAD were more likely to be undergoing maintenance bronchodilator therapy (16/21; 76.2%) than those without SAD (8/31; 25.8%) (p = 0.015). Fourteen CPFE patients met the criteria for bronchial responsiveness. CPFE patients who responded to bronchodilators had lower R5-R19 values than non-responders (0.04 ± 0.02 vs. 0.09 ± 0.06 kPa·s·L−1; p = 0.04). Discussion: Although AOS parameters did not significantly change following bronchodilator administration, this study underscores the value of AOS in detecting peripheral airway dysfunction, which may be under-recognized by conventional spirometry. Conclusions: AOS shows promise as a diagnostic adjunct for identifying SAD in CPFE patients and may complement standard pulmonary function testing in clinical practice. Further multicenter studies with larger cohorts are warranted to validate these findings and investigate the longitudinal impact of SAD on disease progression and treatment outcomes in CPFE. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Pulmonary Diseases)
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Review

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18 pages, 1537 KB  
Review
Transbronchial Lung Cryobiopsy and Awake Video-Assisted Thoracic Surgery in Interstitial Lung Disease: Complementary Roles in a Stepwise Diagnostic Approach
by Umberto Masi, Alessandro Sanduzzi Zamparelli and Stefano Sanduzzi Zamparelli
Diagnostics 2026, 16(13), 2095; https://doi.org/10.3390/diagnostics16132095 - 3 Jul 2026
Viewed by 147
Abstract
The diagnostic evaluation of interstitial lung diseases (ILDs) remains challenging when clinical assessment and imaging findings are inconclusive. Although surgical lung biopsy has traditionally represented the diagnostic gold standard, its invasiveness and perioperative risks limit its applicability, particularly in patients with advanced disease [...] Read more.
The diagnostic evaluation of interstitial lung diseases (ILDs) remains challenging when clinical assessment and imaging findings are inconclusive. Although surgical lung biopsy has traditionally represented the diagnostic gold standard, its invasiveness and perioperative risks limit its applicability, particularly in patients with advanced disease or impaired respiratory reserve. This review aims to examine the evolving roles of transbronchial lung cryobiopsy (TBLC) and awake video-assisted thoracoscopic surgery (Awake VATS) within contemporary diagnostic pathways for ILD. A narrative review of the current literature was performed, focusing on studies evaluating the diagnostic performance, safety profiles, clinical indications, and complementary integration of TBLC and Awake VATS in patients with suspected ILD. Evidence from multidisciplinary ILD referral centers and recent guideline recommendations was critically analyzed. TBLC has progressively emerged as an appropriate first-line histological procedure in many ILD centers, providing a pooled diagnostic yield of approximately 80% with an acceptable safety profile. Awake VATS has refined the surgical approach by preserving spontaneous ventilation while maintaining high diagnostic accuracy. Current evidence suggests that these techniques should be considered complementary rather than competitive. A TBLC-first strategy, followed by selective surgical escalation when endoscopic sampling is non-diagnostic or insufficient, appears to achieve diagnostic accuracy comparable to upfront surgical biopsy while reducing complications, length of hospital stay, and overall patient burden. The choice between Awake VATS and conventional surgical biopsy should be individualized according to patient characteristics, institutional expertise, and available resources. TBLC and Awake VATS represent complementary tools within a multidisciplinary, personalized, and risk-adapted diagnostic framework for ILD. Their integrated use enables optimization of diagnostic accuracy while minimizing procedural invasiveness and improving patient safety, supporting a stratified approach to histological assessment in contemporary clinical practice. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Pulmonary Diseases)
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