Interobserver variability in high-resolution CT of the lungs
- PMID: 32258248
- PMCID: PMC7115039
- DOI: 10.1016/j.ejro.2020.100228
Interobserver variability in high-resolution CT of the lungs
Abstract
Purpose: To quantify the interobserver variability among the most frequently encountered parenchymal patterns in High Resolution CT (HRCT) and to compare the interobserver variability in the application of the 2011 and 2018 usual interstitial pneumonia (UIP) criteria according to the joint guidelines from international thoracic and respiratory societies.
Material and methods: Two observers independently evaluated 126 HRCT, with examples of most common parenchymal patterns, and noted the presence of each pattern. The readers also noted whether the findings met the 2011 criteria for UIP. In a second reading, the same readers noted whether the HRCT met the UIP criteria according to the 2018 UIP update.
Results: The kappa values for interobserver variability for the different patterns ranged from 0.28 (intralobular lines) to 0.85 (tree-in-bud nodules). The kappa value for UIP pattern was similar for 2011 and 2018 criteria, 0.58 and 0.69, respectively. Compared to the 2011 UIP criteria, there was no statistically significant difference in the number of HRCT classified as UIP using the 2018 criteria.
Conclusions: There is a substantial variation in interobserver agreement between the different parenchymal patterns, which suggests that some patterns a more easily identified than others. There is also a considerable reader variation in the assessment of UIP applying the 2011 UIP criteria as well as applying the 2018 UIP update.
Keywords: ATS/ERS/JRS/ALAT, American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Society; CI, Confidence Interval; HRCT; HRCT, High-resolution Computed Tomography; IPF, Idiopathic Pulmonary Fibrosis; Idiopathic pulmonary fibrosis; Inter-reader variation; Interobserver variation; MDCT, Multi-detector Computed Tomography; UIP, Usual Interstitial Pneumonia; Usual interstitial pneumonia.
© 2020 The Authors.
Conflict of interest statement
The authors declare that there is no conflict of interest.
Figures
Similar articles
-
Comparison between the ATS/ERS/JRS/ALAT criteria of 2011 and 2018 for Usual Interstitial Pneumonia on HRCT: a cross-sectional study.Br J Radiol. 2021 Apr 1;94(1120):20201159. doi: 10.1259/bjr.20201159. Epub 2021 Feb 4. Br J Radiol. 2021. PMID: 33539231 Free PMC article.
-
Heterogeneity of incidence and outcome of acute exacerbation in idiopathic interstitial pneumonia.Respirology. 2016 Nov;21(8):1431-1437. doi: 10.1111/resp.12862. Epub 2016 Jul 26. Respirology. 2016. PMID: 27460223
-
Interobserver agreement for the ATS/ERS/JRS/ALAT criteria for a UIP pattern on CT.Thorax. 2016 Jan;71(1):45-51. doi: 10.1136/thoraxjnl-2015-207252. Epub 2015 Nov 19. Thorax. 2016. PMID: 26585524
-
Meta-Analysis of Interobserver Agreement in Assessment of Interstitial Lung Disease Using High-Resolution CT.Radiology. 2024 Oct;313(1):e240016. doi: 10.1148/radiol.240016. Radiology. 2024. PMID: 39404631
-
Tissue Continues to Be the Issue: Role of Histopathology in the Context of Recent Updates in the Radiologic Classification of Interstitial Lung Diseases.Arch Pathol Lab Med. 2019 Jan;143(1):30-33. doi: 10.5858/arpa.2018-0134-RA. Arch Pathol Lab Med. 2019. PMID: 30785335 Review.
Cited by
-
Phenotyping of COPD with MRI in comparison to same-day CT in a multi-centre trial.Eur Radiol. 2024 Sep;34(9):5597-5609. doi: 10.1007/s00330-024-10610-0. Epub 2024 Feb 12. Eur Radiol. 2024. PMID: 38345607 Free PMC article.
-
Pulmonary Hypertension in Association with Lung Disease: Quantitative CT and Artificial Intelligence to the Rescue? State-of-the-Art Review.Diagnostics (Basel). 2021 Apr 9;11(4):679. doi: 10.3390/diagnostics11040679. Diagnostics (Basel). 2021. PMID: 33918838 Free PMC article. Review.
-
Improving Prognostication in Pulmonary Hypertension Using AI-quantified Fibrosis and Radiologic Severity Scoring at Baseline CT.Radiology. 2024 Feb;310(2):e231718. doi: 10.1148/radiol.231718. Radiology. 2024. PMID: 38319169 Free PMC article.
-
Risk factors and prognostic indicators for progressive fibrosing interstitial lung disease: a deep learning-based CT quantification approach.Eur Radiol. 2025 Jun 17. doi: 10.1007/s00330-025-11714-x. Online ahead of print. Eur Radiol. 2025. PMID: 40526353
-
Detection and Monitoring of Interstitial Lung Disease in Patients with Systemic Sclerosis.Curr Rheumatol Rep. 2022 May;24(5):166-173. doi: 10.1007/s11926-022-01067-5. Epub 2022 May 1. Curr Rheumatol Rep. 2022. PMID: 35499699 Free PMC article. Review.
References
-
- Prosch H., Schaefer-Prokop C.M., Eisenhuber E., Kienzl D., Herold C.J. CT protocols in interstitial lung diseases--a survey among members of the European Society of Thoracic Imaging and a review of the literature. Eur. Radiol. 2013;23:1553–1563. - PubMed
-
- Vikgren J., Johnsson A.A., Flinck A., Kheddache S., Milde H., Båth M. High-resolution computed tomography with 16-row MDCT: a comparison regarding visibility and motion artifacts of dose-modulated thin slices and “step and shoot” images. Acta Radiol. 2008;49:755–760. - PubMed
-
- Raghu G., Collard H.R., Egan J.J., Martinez F.J., Behr J., Brown K.K., Colby T.V., Cordier J.-F., Flaherty K.R., Lasky J.A., Lynch D.A., Ryu J.H., Swigris J.J., Wells A.U., Ancochea J., Bouros D., Carvalho C., Costabel U., Ebina M., Hansell D.M., Johkoh T., Kim D.S., King T.E., Kondoh Y., Myers J., Müller N.L., Nicholson A.G., Richeldi L., Selman M., Dudden R.F., Griss B.S., Protzko S.L., Schünemann H.J. ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis, An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am. J. Respir. Crit. Care Med. 2011;183:788–824. - PMC - PubMed
LinkOut - more resources
Full Text Sources
Miscellaneous