Meta-Analysis of Interobserver Agreement in Assessment of Interstitial Lung Disease Using High-Resolution CT.
IF 12.1
1区 医学
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Liam Delaney, Samer Alabed, Ahmed Maiter, Mahan Salehi, Marcus Goodlad, Hassan Shah, Elliot Checkley, Sue Matthews, Mohamed Kamil, Oscar Evans, Smitha Rajaram, Christopher Johns, Nicholas J Screaton, Andrew J Swift, Krit Dwivedi
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Abstract
Background High-resolution CT (HRCT) is central to the assessment of interstitial lung disease (ILD), and accurate classification of disease has important implications for patients. Evaluation of imaging features can be challenging, even for experienced thoracic radiologists. Previous work has provided equivocal evidence on the interpretation of HRCT features at ILD-related imaging. Purpose To perform a meta-analysis to assess the level of agreement among expert thoracic radiologists in interpreting ILD-related imaging. Materials and Methods A systematic literature search from January 2000 to October 2023 of the Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases was performed for articles reporting assessments of interobserver agreement between thoracic radiologists for evaluation of ILD findings, such as severity and progression of disease, presence of features such as honeycombing and ground-glass opacification, and classification based on the 2011 and 2018 American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Asociación Latinoamericana del Tórax (ATS/ERS/JRS/ALAT) guidelines for idiopathic pulmonary fibrosis (IPF). Meta-analysis was performed using a random-effects model to obtain pooled κ or intraclass correlation coefficient (ICC) values as measures of interobserver agreement. Results The final analysis included 13 studies consisting of 6943 images and 146 radiologists. In 10 studies assessing agreement of specific radiologic findings in ILD, the pooled κ value was 0.56 (95% CI: 0.43, 0.70). In eight studies, the assessed interobserver agreement of the ATS/ERS/JRS/ALAT diagnostic guidelines for IPF based on usual interstitial pneumonia (UIP) patterns, the pooled κ value was 0.61 (95% CI: 0.48, 0.74). One study reported a κ value of 0.87 for ILD progression. Seven studies assessing ILD severity could not be pooled; the individual κ values for ILD severity ranged from 0.64 to 0.90, and ICC values ranged from 0.63 to 0.96. Conclusion There was moderate agreement between thoracic radiologists when assessing ILD features and UIP pattern diagnosis but little evidence on agreement of disease severity, extent, or progression. Meta-analysis registry no. PROSPERO CRD42022361803 © RSNA, 2024 Supplemental material is available for this article . See also the editorial by Humbert in this issue.
使用高分辨率 CT 评估间质性肺病的观察者间一致性的 Meta 分析。
背景 高分辨率 CT(HRCT)是评估间质性肺病(ILD)的核心,准确的疾病分类对患者有重要影响。即使对于经验丰富的胸部放射科医生来说,评估成像特征也是一项挑战。以往的工作为解释 ILD 相关成像的 HRCT 特征提供了不明确的证据。目的 进行一项荟萃分析,评估胸科放射专家在解释 ILD 相关成像时的一致程度。材料和方法 2000 年 1 月至 2023 年 10 月期间,对 Ovid MEDLINE、Embase 和 Cochrane Central Register of Controlled Trials 数据库进行了系统性文献检索,以寻找报告胸科放射专家在评估 ILD 发现时观察者间一致性评估的文章、根据 2011 年和 2018 年美国胸科学会/欧洲呼吸学会/日本呼吸学会/拉丁美洲肺科学会(ATS/ERS/JRS/ALAT)特发性肺纤维化(IPF)指南进行分类。使用随机效应模型进行了 Meta 分析,以获得作为观察者间一致性度量的集合 κ 或类内相关系数 (ICC) 值。结果 最终分析包括 13 项研究,涉及 6943 张图像和 146 名放射医师。在 10 项评估 ILD 特定放射学发现一致性的研究中,汇总的 κ 值为 0.56(95% CI:0.43,0.70)。有 8 项研究评估了 ATS/ERS/JRS/ALAT 基于常见间质性肺炎 (UIP) 模式的 IPF 诊断指南的观察者间一致性,汇总的 κ 值为 0.61 (95% CI: 0.48, 0.74)。一项研究报告称,ILD进展的κ值为0.87。七项评估 ILD 严重程度的研究无法汇总;ILD 严重程度的单项κ值介于 0.64 到 0.90 之间,ICC 值介于 0.63 到 0.96 之间。结论 在评估 ILD 特征和 UIP 模式诊断时,胸科放射医师之间的一致性适中,但在疾病严重程度、范围或进展方面的一致性证据不足。元分析登记号PROSPERO CRD42022361803 © RSNA, 2024 本文有补充材料。另请参阅本期 Humbert 的社论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。