Observer variation in pattern type and extent of disease in fibrosing alveolitis on thin section computed tomography and chest radiography

doi:10.1016/S0009-9260(05)81847-1

Clinical Radiology

Volume 49, Issue 4, April 1994, Pages 236-240

https://doi.org/10.1016/S0009-9260(05)81847-1 Get rights and content

In fibrosing alveolitis the pattern type on thin section computed tomography (CT) predicts histological appearances at open lung biopsy and the likelihood of response to treatment. To test the level of inter- and intra-observer variability on CT and chest radiography (CXR), the pattern type and extent of disease were assessed by four observers (two experienced, two inexperienced). A total of 126 CT examinations and 108 concurrent postero-anterior chest radiographs were scored on two occasions, at least 8 weeks apart. A confidence rating was assigned to each observation.

Three out of four observers agreed on pattern type in 81% of cases on CT compared with 54% on CXR (kappa coefficient 0.48 and 0.16 for CT and CXR, respectively). Inter-observer variability in categorizing pattern type on CT was lowest in patients with the highest confidence scores (kappa=0.63). Confident observations were associated with extensive or moderately extensive disease (P<0.001), and with a predominantly reticular pattern (P<0.0001). Intra-observer variability for pattern type on CT was less for the experienced observers (kappa=0.78 and 0.70) than for the inexperienced group (kappa=0.50 and 0.37). Inter-observer variability for extent of disease was significantly less on CT than on CXR (standard deviations 7.8% and 9.2% respectively, P<0.001). This study shows that observer variability using a clinical grading system is lower with CT than with chest radiography in fibrosing alveolitis.

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Observer variation in pattern type and extent of disease in fibrosing alveolitis on thin section computed tomography and chest radiography

British Journal of Diseases of the Chest

American Journal of Medicine

Chest

American Journal of Medicine

Clinical Radiology

Natural history and treated course of usual and desquamative interstitial pneumonia

New England Journal of Medicine

Cryptogenic fibrosing alveolitis; clinical features and their influence on survival

Thorax

Disease activity in idiopathic pulmonary fibrosis: CT and pathologic correlation

Radiology

Fibrosing alveolitis: chest radiography and CT as predictors of clinical and functional impairment at follow-up in 26 patients

Radiology

Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high resolution CT

Radiology

High resolution computed tomography as a predictor of lung histology in systemic sclerosis

Thorax

The predictive value of thin-section computed tomography in fibrosing alveolitis

American Review of Respiratory Disease

preliminary criteria for the classification of systemic sclerosis (scleroderma)

Arthritis and Rheumatism

Fibrosing alveolitis: CT-pathologic correlation

Radiology