This study aimed to distinguish radiologic differences between idiopathic pulmonary fibrosis (IPF)-related UIP and secondary UIP using high-resolution chest CT (HRCT). Fifty-three patients were evaluated through qualitative assessment by expert thoracic radiologists and quantitative AI-based texture analysis using AVIEW Lung Texture (Coreline Soft). IPF cases typically showed uniform honeycombing, axial symmetry, and cranio-caudal distribution, whereas secondary UIP presented with more heterogeneous features such as irregular ground-glass opacities (GGO), exuberant honeycombing, and wedge-shaped fibrosis. AVIEW quantified radiologic patterns like honeycombing, reticulations, and GGO. Reticulations were significantly more prevalent in IPF, while GGO was more extensive in secondary UIP. However, the AI software had limitations in differentiating macro- versus micro-honeycombing.
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