Meta-Analysis of Interobserver Agreement in Assessment of Interstitial Lung Disease Using High-Resolution CT

Area of Science:

• Radiology
• Pulmonology
• Medical Imaging Analysis

Background:

• High-resolution CT (HRCT) is crucial for diagnosing interstitial lung disease (ILD).
• Accurate ILD classification impacts patient management.
• Interpreting HRCT features can be challenging for even experienced radiologists.

Purpose of the Study:

• To conduct a meta-analysis evaluating interobserver agreement among thoracic radiologists in interpreting ILD imaging.
• To assess agreement on specific ILD features and diagnostic guidelines.

Main Methods:

• Systematic literature search (Jan 2000-Oct 2023) of Ovid MEDLINE, Embase, and Cochrane databases.
• Meta-analysis using random-effects model to pool kappa (κ) or intraclass correlation coefficient (ICC) values.
• Included 13 studies with 6943 images and 146 radiologists.

Main Results:

• Pooled κ for specific ILD findings was 0.56 (moderate agreement).
• Pooled κ for the usual interstitial pneumonia (UIP) pattern diagnosis was 0.61 (moderate agreement).
• Limited evidence exists for agreement on ILD severity, extent, or progression.

Conclusions:

• Thoracic radiologists demonstrate moderate agreement on ILD features and UIP pattern diagnosis.
• Further research is needed to establish reliable agreement metrics for ILD severity, extent, and progression assessment.