Added value of prone CT in the assessment of honeycombing and classification of usual interstitial pneumonia pattern |
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| Affiliation: | 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 Gil, Songpa-gu, 138-736 Seoul, Republic of Korea;2. Department of Preventive Medicine, Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 Gil, Songpa-gu, 138-736 Seoul, Republic of Korea;3. Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 Gil, Songpa-gu, 138-736 Seoul, Republic of Korea;1. Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland;2. Department of Nuclear Medicine, University Hospital of Zurich, Switzerland;3. Department of Health Science and Technology, ETH Zurich, Switzerland;1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea;2. Center for Bioimaging of New Drug Development, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea;3. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea;4. RF Medical, Seoul, Korea;5. Department of Radiology, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates;1. Medical Physics Department, University Hospital “Maggiore della Carità”, Novara, Italy;2. Radiology Department, University Hospital “Maggiore della Carità”, Novara, Italy;1. Department of Chest Surgery, Onga Nakama Medical Association Onga Hospital, 1725-2 Oaza-Ozaki Ongacho, Onga-gun, Fukuoka 811-4342, Japan;2. Department of Surgery, Onga Nakama Medical Association Onga Hospital,Onga-gun, Japan;3. Department of Emergency, Onga Nakama Medical Association Onga Hospital,Onga-gun, Japan;4. Department of Radiology, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan;5. Second Department of Surgery, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan;1. Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium;2. Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium;3. Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium |
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| Abstract: | ObjectiveTo retrospectively investigate whether prone CT improves identification of honeycombing and classification of UIP patterns in terms of interobserver agreement and accuracy using pathological results as a reference standard.Materials and methodsInstitutional review board approval with waiver of patients’ informed consent requirement was obtained. HRCTs of 86 patients with pathologically proven UIP, NSIP and chronic HP between January 2011 and April 2015 were evaluated by 8 observers. Observers were asked to review supine only set and supine and prone combined set and determine the presence of honeycombing and UIP classification (UIP, possible UIP, inconsistent with UIP). The diagnosis was regarded as correct when UIP pattern on CT corresponded to pathological UIP.ResultsInterobserver agreement of honeycombing identification among radiologists was only fair on the supine and combined set (weighted κ = 0.31 and 0.34). Additional review of prone images demonstrated a significant improvement in interobserver agreement (weighted κ) of UIP classification from 0.25 to 0.33. Prone CT conferred a significant improvement in interobserver agreement of UIP classification for trainee radiologists (from 0.10 to 0.34) while no improvement was found for board-certified radiologists (from 0.35 to 0.31). There were no significant differences in the accuracy of UIP pattern with reference to pathological results between the supine and combined set (78.8% (145/184) and 81.3% (179/220), P = 0.612).ConclusionAdditional review of prone CT can improve overall interobserver agreement of UIP classification among radiologists with variable experiences, particularly for less experienced radiologists, while no improvement was found in honeycombing identification. |
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| Keywords: | Idiopathic interstitial pneumonia UIP classification Honeycombing Prone CT Interobserver agreement |
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