Observer variation in computed tomography of pleural lesions in subjects exposed to indoor asbestos

Abstract

To assess the reliability of computed tomography (CT) in detecting discrete pleural lesions, the interobserver and intra-observer variability in reading the conventional and high-resolution CT (HRCT) scans of 100 volunteers, who had worked for ¢10 yrs in a building with known asbestos contamination, was evaluated.In the first session, pleural abnormalities were detected by a single radiologist (A 1 ) in 13 subjects. In the second session, the scans were read again independently by the same radiologist (A 2 ) and two other experienced radiologists (B, C). The final decision for the presence of pleural lesions was made in a final consensus reading.This gave a diagnosis of pleural abnormalities in 18 subjects, of whom eight (44%) had been detected by all three readers, five (28%) by two readers and four (22%) by only one reader; one scan, rated normal by all readers during the second session, was reconsidered because pleural abnormalities had been noted at the first reading (A 1 ). The intra-observer agreement for reader A was good (kappa (k) 0.68) but the interobserver agreement between the readers was only fair to moderate (weighted k: A 2 -B~0.43, A 2 -C~0.45, B-C~0.26) in the second reading session.In conclusion, when looking for the prevalence of pleural lesions in indoor asbestos exposed subjects, the potential lack of consistency in reporting the presence of small pleural abnormalities must be borne in mind and strict precautions must be taken. Eur Respir J 2001; 17: 916-921.

Reproducibility of image interpretation in MRI of the prostate: application of the sextant framework by two different radiologists

“…Results of ROC analysis of PCA localization to a sextant of the prostate in our study are closer to the general radiologists' performance in detecting extracapsular extension in the study by Mullerad and co-workers [18]. Interobserver and intra-observer agreement on MRI findings in our study are within the respective ranges published for such radiological examinations that are more difficult to interpret [37,40]. MRI of the prostate with a combined endorectal/body-phased-array-coil system at 1.5 T, including axial T1-weighted SE MR images and axial and coronal T2-weighted FSE MR images without fat signal suppression, as performed here, is a technically stable, routine examination of high standard [16,17].…”

“…Several recent studies of radiological examinations whose interpretation is based on imaging signs rather than quantitative data demonstrate that intra-observer agreement tends to be better than inter-observer agreement [35][36][37][38][39][40]. Levels of agreement as measured by the kappa score appear to be higher when distinguishing signs in imaging are more easily defined.…”

“…Inter-observer agreement appears to be more easily affected by increased difficulty of image interpretation. In a recent study [37], agreement on the presence of pleural lesions in CT and HRCT examinations of the chest of subjects exposed to indoor asbestos was substantial for subsequent image interpretation by the same radiologist (kappa score 0.68). However, inter-observer agreement was fair to moderate, with kappa scores ranging from 0.26 to 0.45 [37].…”

“…In a recent study [37], agreement on the presence of pleural lesions in CT and HRCT examinations of the chest of subjects exposed to indoor asbestos was substantial for subsequent image interpretation by the same radiologist (kappa score 0.68). However, inter-observer agreement was fair to moderate, with kappa scores ranging from 0.26 to 0.45 [37]. Differences in the experience with particular radiological examinations appear to influence agreement on findings.…”

Asbestos-Related Diseases in Automobile Mechanics

“…However, our results must be compared cautiously with those reported by (Marcus et al, 1987) due to the selection factors and the use of different tools for the radiological detection of asbestosrelated abnormalities. The prevalence of pleural plaques observed in this study was similar to that observed on HRCT examinations in subjects exposed to indoor asbestos pollution (De Raeve et al, 2001) or in urban transportation workers with low cumulative exposure to asbestos (Ameille et al, 2007).…”