Jacob J, Aksman L, Mogulkoc N, et al. - As the rates of annualized forced vital capacity (FVC) often decline within the range of measurement variation (5.0%–9.9%) among cases with idiopathic pulmonary fibrosis (IPF) receiving antifibrotic medication and patients with non-IPF fibrosing lung disease, researchers here investigated the value of change in visual CT variables for confirming whether marginal FVC reduction represented genuine clinical deterioration rather than measurement noise. Paired volumetric CTs (acquired between 6 and 24 months from baseline) in two IPF cohorts (cohort 1: n = 103, cohort 2: n = 108) were scored by separate pairs of radiologists. Per multivariate analysis adjusted for patient age, gender, antifibrotic use and baseline disease severity (diffusing capacity for carbon monoxide), change in traction bronchiectasis severity was predictive of mortality independent of FVC decline. Across all study patients with marginal FVC declines, change in traction bronchiectasis severity was an independent predictor of mortality and led to identification of more patients with deterioration than change in honeycombing extent.