Pulmonary hypertension (PH) is a known complication of pulmonary sarcoidosis with a prevalence ranging from 5% to 74% [1]. The aetiology of PH in sarcoidosis is not fully understood. Usually, it is attributed to the destruction of the distal capillary bed by lung fibrosis and/or chronic hypoxaemia. However, the severity of PH does not correlate consistently with the degree of pulmonary fibrosis, and PH exists in sarcoidosis patients without fibrosis, suggesting a multifactorial mechanism. The presence of PH is associated with a poor prognosis, and early diagnosis and treatment might improve outcome [1]. Echocardiography should always be performed when PH is suspected [2]. However, the accuracy of echocardiography in patients with interstitial lung diseases is often limited due to poor image quality and unreliable tricuspid regurgitation signal to measure the right ventricular systolic pressure (RVSP) [3]. Further invasive investigation with the gold standard, right heart catheterisation (RHC), is often required. In order to optimise the noninvasive diagnostic approach, there is a need for more accurate predictors of PH. Computed tomography (CT) may raise suspicion of PH in symptomatic patients or those examined for unrelated indications by showing an increased pulmonary artery (PA) diameter (⩾29 mm) and PA diameter/ascending aorta diameter (AAD) ratio (⩾1.0) [2]. Similarly, PA diameter indexed to body surface area (BSA) has been suggested as possible predictor of PH. However, these parameters have never been investigated in pulmonary sarcoidosis specifically.In this study, PA diameter measurements on chest CT were retrospectively evaluated as predictors of PH. Patients suspected of PH and referred for analysis between November 2007 and May 2014 were included in cases with a consensus diagnosis of pulmonary sarcoidosis, aged ⩾18 years, with availability of chest CT within 1 year of PH analysis. The analysis protocol was based on the European PH guideline [2], and consisted of an ECG, laboratory testing, and echocardiographic assessment of RVSP and secondary parameters. Subsequently, patients were classified as "PH likely" (RVSP >50 mmHg), "PH possible" (RVSP of 36-50 mmHg or presence of secondary signs with normal/absent RVSP signal) or "PH unlikely" (RVSP <36 mmHg or absence of signal without secondary signs). RHC was performed if PH was possible or likely. PH was defined as an invasively measured mean PA pressure (mPAP) ⩾25 mmHg. Patients were divided into three groups: "PH confirmed by RHC", "no PH confirmed by RHC" and "no PH based on echocardiography".

Purpose To determine inter-rater reliability of sarcoidosisrelated computed tomography (CT) findings that can be used for scoring of thoracic sarcoidosis. Materials and methods CT images of 51 patients with sarcoidosis were scored by five chest radiologists for various abnormal CT findings (22 in total) encountered in thoracic sarcoidosis. Using intra-class correlation coefficient (ICC) analysis, inter-rater reliability was analysed and reported according to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) criteria. A pre-specified sub-analysis was performed to investigate the effect of training. Scoring was trained in a distinct set of 15 scans in which all abnormal CT findings were represented. Results Median age of the 51 patients (36 men, 70 %) was 43 years (range 26 -64 years). All radiographic stages were present in this group. ICC ranged from 0.91 for honeycombing to 0.11 for nodular margin (sharp versus illdefined). The ICC was above 0.60 in 13 of the 22 abnormal findings. Sub-analysis for the best-trained observers demonstrated an ICC improvement for all abnormal findings and values above 0.60 for 16 of the 22 abnormalities. Conclusions In our cohort, reliability between raters was acceptable for 16 thoracic sarcoidosis-related abnormal CT findings. Key Points• Thoracic sarcoidosis is common; knowledge on reliability of CT scoring is limited.• Scoring CT abnormalities in pulmonary sarcoidosis can achieve good inter-rater agreement.• CT scoring validation in thoracic sarcoidosis is important for diagnostic and prognostic studies.

(1) Interactive use of currently available CAD software did not improve the radiologists' detection performance of lung nodules on chest radiographs. (2) Independently combining the interpretations of the radiologist and the CAD system improved detection of lung nodules on chest radiographs.

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