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Influence of thoracic radiology training on classification of interstitial lung diseases

  • Marcia Lange
    Affiliations
    Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Priyanka Boddu
    Affiliations
    Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Ayushi Singh
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Benjamin D. Gross
    Affiliations
    Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Xueyan Mei
    Affiliations
    BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Zelong Liu
    Affiliations
    BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Adam Bernheim
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Michael Chung
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Mingqian Huang
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Joy Masseaux
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Sakshi Dua
    Affiliations
    Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Samantha Platt
    Affiliations
    Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Ganesh Sivakumar
    Affiliations
    Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Cody DeMarco
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Justine Lee
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Zahi A. Fayad
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America

    BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Yang Yang
    Affiliations
    BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Maria Padilla
    Affiliations
    Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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  • Adam Jacobi
    Correspondence
    Corresponding author at: Box 1234, One Gustave L. Levy Place, New York, NY 10029, United States of America.
    Affiliations
    Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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      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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