Background: This study aimed to identify distinct metabolic signatures associated with disease progression by integrating high-resolution computed tomography (HRCT) visual scoring with comprehensive metabolomic profiling. Materials and Methods: This single-center, cross-sectional study enrolled 60 idiopathic pulmonary fibrosis/interstitial lung disease (IPF/ILD) patients with usual interstitial pneumonia pattern. Participants underwent standardized pulmonary function testing, HRCT imaging, and peripheral blood collection for metabolomic analysis using one-dimensional hydrogen nuclear magnetic resonance spectroscopy and ultra-high-performance liquid chromatography coupled to tandem mass spectrometry. Linear regression analysis integrated radiographic scores with metabolomic profiles, adjusted for multiple covariates. Results: Stable IPF/ILD exhibited moderate negative correlations between the six most significant metabolites and HRCT scores (r = −0.27 to −0.51), along with a high abundance of specific phospholipids (triacylglycerol, monoacylglycerol, phosphatidylglycerol, phosphatidylethanolamine, diacylglycerol), sphingomyelin, ceramide, and acylcarnitine. In contrast, progressive disease showed weak positive correlations between the six most significant metabolites and HRCT scores (r = 0.19–0.26), and moderate negative correlation between specific triacylglycerol species and HRCT scores (r = −0.37–0.4). Furthermore, metabolomic analysis in individuals with progressive disease revealed both high and low abundances of specific phospholipid species (including high and low triacylglycerol species, as well as low levels of phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, phosphatidylserine, and phosphatidylinositol), along with high levels of certain sphingomyelin, ceramide, taurine, and purine bases, and low levels of xanthine and lactic acid observed. Conclusions: Integration of systematic HRCT semi-quantitative scoring with metabolomic profiling successfully differentiated stable from progressive IPF/ILD through distinct molecular-radiographic signatures.

This case series describes an imaging finding seen in patients following lymphangiography—lace-like hyperdensities outlining the pulmonic lymphatic pathways—termed the spiderweb sign . In a retrospective review of patients who underwent lymphangiograms at a large tertiary care hospital from January 2022 to December 2025, 11 patients had CT thorax images within 1 week of the procedure, and 4 of these patients demonstrated the spiderweb sign. Specifically, the spiderweb sign manifests as hyperdense linear opacities outlining the interlobular septa, peribronchovascular interstitium, and visceral pleura. We present the 4 representative cases illustrating the imaging findings. For the cohort, procedural parameters were collected to assess associations with the presence or absence of the imaging finding, but no definitive association was found. While the exact mechanism remains unclear, these findings parallel patterns seen in prior studies and appear clinically benign. An additional literature review of pulmonary findings following lymphangiography was conducted to contextualize the spiderweb sign. Awareness of these postprocedural imaging findings as expected findings rather than developing pathology is essential to prevent misinterpretation. Larger multicenter studies are needed to clarify procedural factors and the underlying pathophysiology.

Background: Exposure to musculoskeletal (MSK) imaging is limited in medical education. Radiology integration and module-based learning have been previously shown to improve learning when integrated with anatomy education. This project aims to create, implement, and assess self-directed, image-based modules to enhance visuospatial understanding of MSK anatomy among undergraduate medical students. We hypothesize that students using this resource will show greater anatomical understanding and higher end-of-course examination scores. Methods: Two modules incorporating interactive interfaces and cross-sectional imaging with MSK anatomy were integrated into the preclinical MSK course at a single U.S. M.D. program. Data on student engagement with the module were compared with performance on the end-of-course written examination and practical examination. Subjective data on the perceived efficacy of the educational resource were collected. Results: Between the academic years of 2022 and 2025, 114 (23.5%) and 165 (33.8%) second-year medical students completed the optional spine and upper extremity modules, respectively, from 488 total enrolled in the MSK course. Those who completed the spine module and the upper extremity module had a mean 3.5% increase (p < 0.0001) and 3.3% increase (p = 0.00025) in final practical anatomy examination scores compared with those who did not use the modules. Usage of the module did not result in a statistically significant increase in final written examination scores. 98.0% of respondents on the postmodule survey reported that the modules improved their understanding of MSK anatomy. Conclusion: The results from the collected data show utilization of interactive modules incorporating imaging alongside MSK anatomy specifically improved performance on practical anatomy assessments. Integration of cross-sectional and radiologic imaging in MSK anatomy instruction can improve visuospatial understanding of anatomy among medical trainees and can be an effective method to prepare them for clinical application.