Idiopathic Lung fibrosis - semiquantitative grading of fibrotic and ground glass score

Gay et al. used a semiquantitative score to objectively assess the extent of lung fibrosis. In the study, each lobe was scored separately and mean of all lobes was used as a fibrotic, ground glass, and total score for each patient.

Alveolar score Description
0 no alveolar disease
1 ground glass opacity involving <5% of the lobe (minimal disease)
2 ground glass opacity involving <25% of the lobe
3 ground glass opacity involving 25 - 49% of the lobe
4 ground glass opacity involving 50 - 75% of the lobe
5 ground glass opacity involving >75% of the lobe
Interstitial score Description
0 no interstitial disease
1 interlobular septal thickening, no discrete honeycombing
2 honeycombing (± septal thickening) involving up to 25% of the lobe
3 honeycombing (± septal thickening) involving 25 -49% of the lobe
4 honeycombing (± septal thickening) involving 50 - 75% of the lobe
5 honeycombing (± septal thickening) involving >75% of the lobe


1. Gay, Steven E., Ella A. Kazerooni, Galen B. Toews, JOSEPH P. LYNCH III, Barry H. Gross, Phillip N. Cascade, David L. Spizarny et al. "Idiopathic pulmonary fibrosis: predicting response to therapy and survival." American journal of respiratory and critical care medicine 157, no. 4 (1998): 1063-1072.
2. Kazerooni, E. A., Martinez, F. J., Flint, A., Jamadar, D. A., Gross, B. H., Spizarny, D. L., ... & Toews, G. (1997). Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring. AJR. American journal of roentgenology, 169(4), 977-983.
3. Sterclova M., Vasakova M. Quantification of parenchymal involvement in patients with fibrosing interstitial lung diseases. Ces Radiol 2013;67(3):204-208.