Multimodal diagnosis of interstitial lung diseases: integrating biomarkers, microRNAs, and CT radiomics

Background. The diagnosis of interstitial lung diseases is complicated by the absence of specific symptoms and incomplete understanding of pathogenesis. Despite their relatively low prevalence, these conditions are often identified with delay, which worsens the prognosis. Contemporary approaches emphasize the need for multimodal management combining clinical assessment, imaging, pulmonary function testing, and, when indicated, lung biopsy. Purpose – to characterize current approaches to the diagnosis of interstitial lung diseases based on open sources of information. Materials and Methods. A systematic search was conducted in international bibliometric databases and information retrieval systems, focusing primarily on publications from the past five years. Studies were selected according to their relevance to the aims and objectives of the review. Results. The key challenges are disease heterogeneity and the lack of universal biomarkers. The most promising strategy is a multimodal approach integrating genetic, epigenetic, histological, and radiological analyses to optimize diagnostic algorithms. Demonstrated effectiveness includes a combination of genetic polymorphism assessment in telomerase-complex and mucin genes, measurement of serum biomarkers (including surfactant proteins A and D, antibodies to specific innate immunity proteins), analysis of micro ribonucleic acids (e.g., miR-101 and miR-21), and the use of high-resolution computed tomography with radiomics (including FibroScore). Conclusions. Integrating genetic, epigenetic, histological, and radiological levels improves diagnostic accuracy, reduces errors, enhances patient stratification, and supports prediction of fibrosis progression. This aligns with Goal 3, «Ensure healthy lives and promote well-being for all at all ages», of the «Seventeen Sustainable Development Goals» promoted by the United Nations. A three-stage algorithm (genetic screening → epigenetic assessment → radiological segmentation) enables personalized therapy and early initiation of antifibrotic treatment, thereby improving patient prognosis.