During her second CPFF fellowship year, Dr. Avitzur has continued to investigate a number of research questions and expand her skills, making contributions to quality-of-life issues for patients, providing guidance for clinicians, and using AI and machine learning applications to CT analysis to aid researchers.
Expert treatment patterns in patients with ILD
For her main research project, Dr. Avitzur examined which patient features influence treatment decisions by expert ILD physicians, using previously collected patient information from the CARE-PF (Canadian Registry for Pulmonary Fibrosis).
200 real cases were selected, including medical histories, CT scans and radiologist reports, along with other information, and posted online. Cases were sent to 13 ILD experts across the country (many former CPFF Fellows) to obtain their treatment recommendations for these specific cases. For some cases, a lung biopsy report was added later and the experts were asked whether, and how, the biopsy results changed their diagnosis and/or treatment plans.
“We found certain CT features that drive treatment decisions,” says Dr. Avitzur. “Additionally, ILD physicians use complementary information from both diagnosis (medical history, breathing tests, etc.) as well as CT results in treatment decisions. This means a ‘comprehensive’ approach is used in making disease management decisions.”
Impact for patients, clinicians and researchers
Most ILD patients have a long first appointment with their specialist team. “This helps the team gather as much relevant information as possible, to make an informed diagnosis and treatment plan for each individual patient,” says Dr. Avitzur. “These findings should help guide ILD treatment decisions for physicians, and respirologists at every level,” says Dr. Avitzur. “In turn, the more aware and informed clinicians are, the better the care they can deliver to their patients.”
She presented a poster of the findings at the Canadian Respirology Conference in April, 2026. The manuscript “Treatment patterns in fibrotic ILD: Radiologic and clinical features that drive management decisions,” is currently being reviewed for publication.
Learning and applying the newest research skills
Dr. Avitzur has a keen interest in how AI, and machine learning can be used to quantify various features and anomalies within a CT the lungs. These advanced techniques can count many areas of CT such as airways, blood vessels, veins, fibrosis burdne, and measure changes over time.
She spent the final three months of her fellowship in London, England, working with Professor Joseph Jacob at University College London (UCL), developing skills in using artificial intelligence (AI) and CT machine learning. While there, she built an imaging dataset of more than 700 patients from B.C., focusing on patients with scleroderma-related ILD. She is now analyzing this data.
Impact and further AI research
“These new imaging techniques can help find “imaging markers,” that can provide clues to how quickly someone’s disease may progress and track how they respond to treatment, and possibly signify the correct choice of medication,” says Dr. Avitzur. “It may also help us determine if they need oxygen therapy, and how to better manage other symptoms.”
“This is not used clinically yet, but it is an exciting area of research with lots of potential. We may discover something from these CT imaging markers, which are less invasive than biopsies, which advances our knowledge of the disease. There could be something there, right under our noses, that can help us learn about PF.”
For now, this work is primarily of interest to researchers, but incorporation in clinical trials is beginning, reports Dr. Avitzur. She also presented this work at the Canadian Respiratory Conference in 2026, increasing awareness among other clinicians and researchers.
Using AI to quantify lung damage
Dr. Avitzur is working on an additional project using an AI technique to quantify lung damage on CT in patients with scleroderma-related ILD. This study will result in a manuscript for publication. An abstract of this work was accepted by the International Colloquium on Lung and Airway Fibrosis, which takes place every two years. The meeting will be in Sydney, Australia, in October 2026.
Pulmonary fibrosis and sex
In 2026, an earlier study led by Dr. Avitzur was published “The impact of pulmonary fibrosis on sex and sexual function – a multinational mixed methods study.” This study began when she was working in Calgary with Dr. Kerri Johannson.
The study involved 2,760 patients from the CARE-PF registry with 74% of them who reported shortness of breath during sexual activity, as well as a UK study of 225 patients of which 23% were distressed by how their PF affected their sex life. An international survey was conducted in English, French, Spanish and Dutch and gathered a further 140 patients. Seven patients volunteered to do individual interviews to help determine common themes.
“Sexual dysfunction is an issue for about 85 per cent of PF patients,” says Dr. Avitzur. “and it goes beyond physical limitations. There are medication side effects and psychological ones, like a negative self-image, fear, and relationship issues. It is a quality-of-life issue. It’s important to people. And it’s important for physicians to address these issues.”
In some pulmonary rehab programs, an intimacy or sexual activity component is available to patients. “And there are various resources online to address more comfortable sexual positions and activities for specific medical conditions. Check with your doctor for advice, specifically for you,” says Dr. Avitzur.
You may also want to check out and/or share with your doctor the following links provided by Dr. Avitzur, for more information about sex/intimacy in PF and other lung diseases:
- Sex and intimacy when you have a lung condition
- Sex and living with pulmonary fibrosis
- Understanding being close
Other accomplishments and what’s next?
In addition to her research, Dr. Avitzur also completed her Master’s of Health Science and cared for ILD patients at St. Paul’s Hospital in Vancouver. (You can read about her research projects in the first year of her fellowship.)
Dr. Avitzur will begin her new position as a Clinical Assistant Professor in the Department of Medicine, Division of Respirology, at the University of Calgary in September 2026. In addition to caring for ILD patients, she will have 60 per cent of her time protected for research work – a big benefit for her, in her academic career, and for the PF Community.
“I would never have landed this big research position without the CPFF Robert Davidson Fellowship and the guidance and support of my mentors, Dr. Ryerson in Vancouver and Dr Johannson in Calgary. I hope to continue to contribute to our knowledge of ILD in the future for the benefit of our patients.”