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Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Interobserver variability in high-resolution CT of the lungs.

Jonas Widell1, Mats Lidén1

  • 1Department of Radiology, Örebro University Hospital, Region Örebro County, Sweden.

European Journal of Radiology Open
|April 8, 2020
PubMed
Summary

Interobserver variability in High Resolution CT (HRCT) parenchymal patterns is substantial. Agreement on usual interstitial pneumonia (UIP) criteria showed moderate variability, with no significant difference between 2011 and 2018 guidelines.

Keywords:
ATS/ERS/JRS/ALAT, American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic SocietyCI, Confidence IntervalHRCTHRCT, High-resolution Computed TomographyIPF, Idiopathic Pulmonary FibrosisIdiopathic pulmonary fibrosisInter-reader variationInterobserver variationMDCT, Multi-detector Computed TomographyUIP, Usual Interstitial PneumoniaUsual interstitial pneumonia

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Area of Science:

  • Radiology
  • Pulmonary Medicine
  • Thoracic Imaging

Background:

  • High Resolution Computed Tomography (HRCT) is crucial for diagnosing interstitial lung diseases.
  • Usual Interstitial Pneumonia (UIP) is a key pattern requiring accurate identification.
  • International guidelines provide criteria for UIP diagnosis, evolving over time.

Purpose of the Study:

  • To quantify interobserver variability for common HRCT parenchymal patterns.
  • To compare interobserver variability in applying 2011 versus 2018 UIP criteria.
  • To assess agreement on UIP diagnosis based on updated guidelines.

Main Methods:

  • Two independent observers reviewed 126 HRCT scans.
  • Evaluated presence of common parenchymal patterns.
  • Assessed HRCTs for 2011 and 2018 UIP criteria in separate readings.

Main Results:

  • Interobserver agreement varied significantly across patterns (Kappa: 0.28-0.85).
  • Kappa for UIP pattern was 0.58 (2011) and 0.69 (2018).
  • No statistically significant difference in HRCT classification as UIP between 2011 and 2018 criteria.

Conclusions:

  • Significant interobserver variability exists for identifying various HRCT parenchymal patterns.
  • Moderate reader variation in assessing UIP using both 2011 and 2018 criteria.
  • The updated 2018 UIP criteria did not significantly alter classification compared to 2011.