Observer variation in pattern type and extent of disease in fibrosing alveolitis on thin section computed tomography and chest radiography

Collins, Carleen; Wells, Athol U.; Hansell, David M.; Morgan, Robert; MacSweeney, J.E.; Bois, Roland M. du; Rubens, M B

doi:10.1016/s0009-9260(05)81847-1

Cited by 109 publications

(78 citation statements)

References 26 publications

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“…Since the radiological criteria for the diagnosis of UIP on HRCT were not mentioned in this latter study, it is not possible to explain the difference between their kw and those of MACDONALD et al [9], FLAHERTY et al [3] and the present study. Other studies [8,10,19,20], however, have found a higher level of agreement, but their study populations and the purposes for which observer variability were calculated differed significantly from those of the present study (table 4). AZIZ et al [21] found an observer agreement of 0.48 on the first-choice diagnosis in a cohort of 131 patients with diffuse parenchymal lung disease; the kw in the IPF cohort was 0.50.…”

Section: Discussioncontrasting

confidence: 79%

“…Various studies have calculated the accuracy of thoracic HRCT in fibrotic lung diseases [5][6][7], evaluated interobserver agreement for the diagnosis of different thoracic HRCT patterns (e.g. ground-glass and reticular pattern) [8,9] in patients with biopsy-proven nonspecific interstitial pneumonia (NSIP) or UIP [3], or in different forms of interstitial lung disease [10,11]. Studies on interobserver agreement amongst pathologists are sparse [12], and only one study with a multicentric prospective design has addressed the issue of diagnostic accuracy in UIP in relation to both radiologist and pathologist [7].…”

mentioning

confidence: 99%

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Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Thomeer¹,

Demedts²,

Behr³

et al. 2007

Eur Respir J

140

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The purpose of the present study was to evaluate the accuracy of the diagnosis of idiopathic pulmonary fibrosis (IPF) by respiratory physicians in six European countries, and to calculate the interobserver agreement between high-resolution computed tomography reviewers and histology reviewers in IPF diagnosis.The diagnosis of usual interstitial pneumonia (UIP) was assessed by a local investigator, following the American Thoracic Society/European Respiratory Society consensus statement, and confirmed when a minimum of two out of three expert reviewers from each expert panel agreed with the diagnosis. The level of agreement between readers within each expert panel was calculated by weighted kappa.The diagnosis of UIP was confirmed by the expert panels in 87.2% of cases. A total of 179 thoracic high-resolution computed tomography scans were independently reviewed, and an interobserver agreement of 0.40 was found. Open or thoracoscopic lung biopsy was performed in 97 patients, 82 of whom could be reviewed by the expert committee. The weighted kappa between histology readers was 0.30.It is concluded that, although the level of agreement between the readers within each panel was only fair to moderate, the overall accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis in expert centres is good (87.2%).

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Section: Discussioncontrasting

confidence: 79%

mentioning

confidence: 99%

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Thomeer¹,

Demedts²,

Behr³

et al. 2007

Eur Respir J

140

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“…Since many treatable disorders with more favorable prognoses may mimic IPF, a lung biopsy is essential in patients clinically suspected to have IPF. However, recent retrospective studies have shown HRCT to be quite specific at making a diagnosis, without the need for an open lung biopsy (5,6,(10)(11)(12)(13)(14). The aim of this study was to determine the value of clinical and radiological findings in diagnosis IPF.…”

Section: Discussionmentioning

confidence: 98%

A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia

Kurt¹,

Uçar²,

Alpar³

et al. 2014

Turk J Bioch

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Pulmoner fibrozisin histolojik bulguları, yüksek çözünürlüklü bilgisayarlı tomografideki (YRBT) radyolojik bulgular ile kuvvetle ilişkilidir ve aynı zamanda buzlu cam görünümü, interstisyel inflamasyon ile ilişkilidir. Biz, usual interstisyel pnömoni ( UİP ) olan hastalarda YRBT bulguları ile histolojik korelasyonu araştırmayı amaçladık. Yöntem: Açık akciğer biyopsisi ile UIP tanısı teyit edilen hastaların kayıtları retrospektif olarak incelendi. Semptomların süresi, fizik muayene bulguları, solunum fonksiyon ve difüzyon testi sonuçları ve arteriyel kan gazı analizi sonuçları kaydedildi. İki deneyimli patolog tarafından, tanının teyidi için patoloji örnekleri ATS / ERS kriterleri göz önüne alınarak tekrar incelendi. YRBT görüntüleri de bir radyolog tarafından tekrar değerlendirildi. Klinik, histopatolojik ve radyolojik bulgular kaydedildi ve karşılaştırıldı. Bulgular: UIP patolojik tanısı olan on hastanın hepsinde mikroskobik bal peteği görünümü vardı. HRCT'de bal peteği görünümü 9 hastada gözlendi, bunların 3 tanesinde kistik oluşumda vardı. Mikroskobik incelemede fibroblastik odakları olan hastalarda HRCT'de traksiyon bronşektazisi vardı. Sonuç: YRBT bulguları, UIP'li hastalarda mikroskobik bal peteği görünümünü ve fibroblastik odakların varlığını tahminde yardımcı olabilir. Semptomların süresi ile histolojik değişikliklerin derecesi ilişkili değildir.Objective: Histological findings of pulmonary fibrosis correlate strongly with radiological findings on highresolution computed tomography (HRCT) and pure groundglass attenuation correlates with interstitial inflammation. We aimed to investigate histological correlation with HRCT findings in patients with usual interstitial pneumonia (UIP). Method: The records of patients with UIP confirmed with an open lung biopsy were retrospectively reviewed. Duration of symptoms, findings on physical examination, pulmonary function and diffusion test results, and results of arterial blood gas analysis were recorded. Pathology specimens were reexamined by two experienced pathologists for confirmation of the diagnosis taking into consideration ATS/ERS criteria. HRCT images were also reevaluated by a designated radiologist. Clinical, histopathological and radiological findings were recorded and compared. Results: Ten patients had a pathological diagnosis of UIP, all of which also had a microscopic honey comb appearance. Honey comb appearance on HRCT was observed in only 9 patients, 3 of which also had cystic formation. Patients with fibroblastic foci on microscopic examination also had traction bronchiectasis on HRCT. Conclusion: HRCT findings may help predict the presence of microscopic honeycomb appearance and fibroblastic foci consistent with UIP. Duration of symptoms and degree of histological changes are not correlated.

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“…An initial overall analysis of the HRCT (without considering cut-off levels) was conducted, in search of the following findings: nodules, ground-glass opacities, reticular abnormality, honeycombing (cysts < 3 mm and > 3 mm), traction bronchiectasis, air trapping areas and emphysema. (18,19) Subsequently, the HRCT was evaluated as to the extent and intensity of interstitial lung involvement, considering five cut-off levels: 1) origin of major vessels; 2) aortic arch level; 3) carina; 4) confluence of pulmonary veins; and 5) 1 cm above the right diaphragm. (6,(19)(20)(21) Using a semiquantitative evaluation system, each of these levels (right and left, separately, totaling 10 levels) was analyzed as to the following aspects:…”

Section: Methodsmentioning

confidence: 99%

Correlação dos achados tomográficos com parâmetros de função pulmonar na fibrose pulmonar idiopática em não fumantes

et al. 2007

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Objective: To correlate tomographic findings with pulmonary function parameters in patients with idiopathic pulmonary fibrosis (IPF). Methods: A cross-sectional study was carried out, in which 30 nonsmoking patients with IPF were evaluated. Using a semiquantitative scoring system, the following high-resolution computerized tomography (HRCT) findings were quantified: total interstitial disease (TID), reticular abnormality/honeycombing, and ground-glass opacity (GGO). The functional variables were measured by spirometry, forced oscillation technique (FOT), helium dilution method, as well as the single-breath method of measuring diffusion capacity of the lung for carbon monoxide (DLCO). Results: Of the 30 patients studied, 18 were female, and 12 were male, with a mean age of 70.9 years. We found that TID and reticular abnormality and honeycombing correlated significantly (negative correlations) with the measurements of forced vital capacity (FVC), total lung capacity (TLC), DLCO, and dynamic respiratory compliance were found, as well as that GGO correlated significantly (and positively) with residual volume/TLC. The ratio of forced expiratory flow between 25 and 75% of FVC to FVC (FEF 25-75% /FVC) correlated positively with TID, reticular abnormality/honeycombing, and GGO. Conclusion: In IPF patients, the measurements of volume, diffusion, and dynamic compliance are the physiological variables which best reflect the extent of the interstitial disease on HRCT scans.

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Observer variation in pattern type and extent of disease in fibrosing alveolitis on thin section computed tomography and chest radiography

Cited by 109 publications

References 26 publications

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia

Correlação dos achados tomográficos com parâmetros de função pulmonar na fibrose pulmonar idiopática em não fumantes

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