Highlights
- •Thoracic radiologists as compared to other radiologists and a pulmonologist displayed better sensitivity and specificity when diagnosing interstitial lung disease
- •Nonspecific interstitial pneumonia was most accurately diagnosed by thoracic radiologists as compared to other radiologists and a pulmonologist
- •Readers with thoracic radiology training showed the most interreader agreement when classifying interstitial lung diseases based on HRCT images and clinical history
Abstract
Introduction
Interpretation of high-resolution CT images plays an important role in the diagnosis
and management of interstitial lung diseases. However, interreader variation may exist
due to varying levels of training and expertise. This study aims to evaluate interreader
variation and the role of thoracic radiology training in classifying interstitial
lung disease (ILD).
Methods
This is a retrospective study where seven physicians (radiologists, thoracic radiologists,
and a pulmonologist) classified the subtypes of ILD of 128 patients from a tertiary
referral center, all selected from the Interstitial Lung Disease Registry which consists
of patients from November 2014 to January 2021. Each patient was diagnosed with a
subtype of interstitial lung disease by a consensus diagnosis from pathology, radiology,
and pulmonology. Each reader was provided with only clinical history, only CT images,
or both. Reader sensitivity and specificity and interreader agreements using Cohen's
κ were calculated.
Results
Interreader agreement based only on clinical history, only on radiologic information,
or combination of both was most consistent amongst readers with thoracic radiology
training, ranging from fair (Cohen's κ: 0.2–0.46), moderate to almost perfect (Cohen's κ: 0.55–0.92), and moderate to almost perfect (Cohen's κ: 0.53–0.91) respectively. Radiologists with any thoracic training showed both increased
sensitivity and specificity for NSIP as compared to other radiologists and the pulmonologist
when using only clinical history, only CT information, or combination of both (p < 0.05).
Conclusions
Readers with thoracic radiology training showed the least interreader variation and
were more sensitive and specific at classifying certain subtypes of ILD.
Summary sentence
Thoracic radiology training may improve sensitivity and specificity in classifying
ILD based on HRCT images and clinical history.
Keywords
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Article info
Publication history
Accepted:
December 27,
2022
Received in revised form:
December 7,
2022
Received:
September 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
