[Observer variability in the radiologic interpretation of interstitial lung disease]

Area of Science:

• Pediatric Pulmonology
• Radiology
• Pathology

Background:

• Interstitial lung disease (ILD) in children presents diagnostic challenges.
• Accurate interpretation of chest X-rays is crucial for diagnosing pediatric ILD.
• Variability in radiologist interpretation can impact patient management.

Purpose of the Study:

• To assess intra- and interobserver variability in pediatric chest X-ray readings for interstitial lung disease (ILD).
• To determine the influence of clinical data on the interpretation of pediatric ILD X-rays.
• To evaluate the correlation between radiological patterns and histopathology diagnoses in pediatric ILD.

Main Methods:

• Prospective, cross-sectional, comparative, blinded study of 45 pediatric ILD patients.
• Two pediatric pulmonologists independently reviewed chest X-rays three times at two-week intervals.
• Clinical data (age, symptoms, evolution) was provided for the third reading; observers were blinded to previous readings and diagnoses.

Main Results:

• Good intra- and interobserver agreement was observed, with weighted kappa values ranging from 0.57 to 0.88.
• The addition of clinical data did not significantly alter the interpretation patterns.
• Established radiological patterns showed good association with anatomopathological diagnoses.

Conclusions:

• Low variability in X-ray interpretation suggests high reliability among experienced pediatric pulmonologists.
• Radiological pattern classification in pediatric ILD is consistent and correlates well with biopsy-proven diagnoses.
• Shared experience between observers likely contributed to the observed good agreement in ILD assessment.