Junya Tominaga1,2, Alexander A Bankier3, Kyung Soo Lee4, Ann N Leung5, Martine Remy-Jardin6, Masanori Akira7, Hiroaki Arakawa8, Phillip M Boiselle9, Tomás Franquet10, Kiminori Fujimoto11, Pierre Alain Gevenois12, Jin Mo Goo13, Philippe A Grenier14, Hiroto Hatabu15, Kazuya Ichikado16, Jung-Gi Im13, Takeshi Johkoh17, Ki-Nam Lee18, David A Lynch19, Satoshi Noma20, Jae-Woo Song21, Fumikazu Sakai22, Yukihiko Sugiyama23. 1. Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan. jrtomi@jf6.so-net.ne.jp. 2. Department of Diagnostic Radiology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 9808574, Japan. jrtomi@jf6.so-net.ne.jp. 3. Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 4. Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA. 6. Department of Thoracic Imaging, Hôptal Calmette, Université Lille Nord de France, Lille, France. 7. Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan. 8. Department of Radiology, Dokkyo Medical University, Mibu, Japan. 9. Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA. 10. Department of Radiology, Hospital de Sant Pau, Barcelona, Spain. 11. Department of Radiology, Center for Diagnostic Imaging, Kurume University School of Medicine, Kurume, Japan. 12. Department of Radiology, Hôptal Erasme, Université Libre de Bruxelles, Brussels, Belgium. 13. Department of Radiology, Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, South Korea. 14. Department of Radiology, Hôpital Pitié-Salpêtrière, APHP, Université Pierre and Marie Curie, Paris, France. 15. Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA. 16. Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan. 17. Department of Diagnostic Radiology, Kansai Rosai Hospital, Amagasaki, Japan. 18. Department of Radiology, Dong-A University College of Medicine, Busan, South Korea. 19. Department of Radiology, National Jewish Medical and Research Center, Denver, CO, USA. 20. Department of Radiology, Tenri Hospital, Tenri, Japan. 21. Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 22. Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan. 23. Division of Pulmonary Medicine, Nerima-Hikarigaoka Hospital, Tokyo, Japan.
Abstract
PURPOSE: To assess inter-observer variability in identifying traction bronchiectasis on computed tomography (CT) using additional criteria for chronic fibrosing interstitial pneumonia. METHODS: Seven experts categorized CT image set representing 39 patients into three groups on the basis of the presence of traction bronchiectasis, using a three-point scale: 3-definitely/probably yes; 2-possibly yes; and 1-definitely/probably no. This scale served as a reference standard. The image set included cases of chronic fibrosing interstitial pneumonia, non-interstitial lung disease, and difficult-to-determine cases. Forty-eight observers similarly assessed the same image set, first according to the Fleischner Society definition, and second with additional criteria, in which traction bronchiectasis was observed exclusively in chronic fibrosing interstitial pneumonia. The agreement level between the reference standard and each observer's evaluation in each session was calculated using weighted kappa values which were compared between the two sessions using a paired t test. RESULTS: The mean weighted kappa value for all observers was significantly higher in the second reading session (mean 0.75) than in the first reading session (mean 0.62) (p < 0.001). CONCLUSION: Inter-observer agreement in identifying traction bronchiectasis improves when using the additional criteria which specify chronic fibrosing interstitial pneumonia as the underlying disease.
PURPOSE: To assess inter-observer variability in identifying traction bronchiectasis on computed tomography (CT) using additional criteria for chronic fibrosing interstitial pneumonia. METHODS: Seven experts categorized CT image set representing 39 patients into three groups on the basis of the presence of traction bronchiectasis, using a three-point scale: 3-definitely/probably yes; 2-possibly yes; and 1-definitely/probably no. This scale served as a reference standard. The image set included cases of chronic fibrosing interstitial pneumonia, non-interstitial lung disease, and difficult-to-determine cases. Forty-eight observers similarly assessed the same image set, first according to the Fleischner Society definition, and second with additional criteria, in which traction bronchiectasis was observed exclusively in chronic fibrosing interstitial pneumonia. The agreement level between the reference standard and each observer's evaluation in each session was calculated using weighted kappa values which were compared between the two sessions using a paired t test. RESULTS: The mean weighted kappa value for all observers was significantly higher in the second reading session (mean 0.75) than in the first reading session (mean 0.62) (p < 0.001). CONCLUSION: Inter-observer agreement in identifying traction bronchiectasis improves when using the additional criteria which specify chronic fibrosing interstitial pneumonia as the underlying disease.
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