Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring.

Kazerooni, Ella A.; Martínez, Fernando J.; Flint, Andrew; Jamadar, David A.; Gross, Barry H.; Spizarny, David L.; Cascade, Philip N.; Whyte, Richard I.; Lynch, Joseph P.; Toews, Galen B.

doi:10.2214/ajr.169.4.9308447

Cited by 422 publications

(323 citation statements)

References 22 publications

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“…Since the radiological criteria for the diagnosis of UIP on HRCT were not mentioned in this latter study, it is not possible to explain the difference between their kw and those of MACDONALD et al [9], FLAHERTY et al [3] and the present study. Other studies [8,10,19,20], however, have found a higher level of agreement, but their study populations and the purposes for which observer variability were calculated differed significantly from those of the present study (table 4). AZIZ et al [21] found an observer agreement of 0.48 on the first-choice diagnosis in a cohort of 131 patients with diffuse parenchymal lung disease; the kw in the IPF cohort was 0.50.…”

Section: Discussioncontrasting

confidence: 80%

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Thomeer¹,

Demedts²,

Behr³

et al. 2008

European Respiratory Journal

140

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The purpose of the present study was to evaluate the accuracy of the diagnosis of idiopathic pulmonary fibrosis (IPF) by respiratory physicians in six European countries, and to calculate the interobserver agreement between high-resolution computed tomography reviewers and histology reviewers in IPF diagnosis.The diagnosis of usual interstitial pneumonia (UIP) was assessed by a local investigator, following the American Thoracic Society/European Respiratory Society consensus statement, and confirmed when a minimum of two out of three expert reviewers from each expert panel agreed with the diagnosis. The level of agreement between readers within each expert panel was calculated by weighted kappa.The diagnosis of UIP was confirmed by the expert panels in 87.2% of cases. A total of 179 thoracic high-resolution computed tomography scans were independently reviewed, and an interobserver agreement of 0.40 was found. Open or thoracoscopic lung biopsy was performed in 97 patients, 82 of whom could be reviewed by the expert committee. The weighted kappa between histology readers was 0.30.It is concluded that, although the level of agreement between the readers within each panel was only fair to moderate, the overall accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis in expert centres is good (87.2%).

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Section: Discussioncontrasting

confidence: 80%

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Thomeer¹,

Demedts²,

Behr³

et al. 2008

European Respiratory Journal

140

View full text Add to dashboard Cite

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“…An accurate and reproducible method allowing monitoring of fibrosis progression on HRCT would be a valuable surrogate marker of disease. Unfortunately, assessment of fibrosis volumes by expert radiologists has been hampered by substantial intra-and interobserver variability, and quantitative CT indices using fractal analysis and global histogram-based methods have not been validated or found helpful in clinical practice thus far [1,4,[19][20][21][22][23][24]. CALIPER is based on a texture-sensitive volumetric analysis that allows automated classification of lung parenchyma according to a database of HRCT volumes of interest validated by radiologists using data from the LTRC [9].…”

Section: Discussionmentioning

confidence: 99%

Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis

Maldonado

Moua

Rajagopalan³

et al. 2013

European Respiratory Journal

201

139

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Accurate assessment of prognosis in idiopathic pulmonary fibrosis remains elusive due to significant individual radiological and physiological variability. We hypothesised that short-term radiological changes may be predictive of survival.We explored the use of CALIPER (Computer-Aided Lung Informatics for Pathology Evaluation and Rating), a novel software tool developed by the Biomedical Imaging Resource Laboratory at the Mayo Clinic Rochester (Rochester, MN, USA) for the analysis and quantification of parenchymal lung abnormalities on high-resolution computed tomography. We assessed baseline and follow-up (time-points 1 and 2, respectively) high-resolution computed tomography scans in 55 selected idiopathic pulmonary fibrosis patients and correlated CALIPER-quantified measurements with expert radiologists' assessments and clinical outcomes.Findings of interval change (mean 289 days) in volume of reticular densities (hazard ratio 1.91, p50.006), total volume of interstitial abnormalities (hazard ratio 1.70, p50.003) and per cent total interstitial abnormalities (hazard ratio 1.52, p50.017) as quantified by CALIPER were predictive of survival after a median follow-up of 2.4 years. Radiologist interpretation of short-term global interstitial lung disease progression, but not specific radiological features, was also predictive of mortality.These data demonstrate the feasibility of quantifying interval short-term changes on high-resolution computed tomography and their possible use as independent predictors of survival in idiopathic pulmonary fibrosis. @ERSpublications Short-term quantified CT changes are predictive of survival in IPF

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“…The degree of emphysema and any coexisting pulmonary fibrosis were assessed using HRCT scan independently evaluated by two chest radiologists blinded to clinical data and each other's findings. A visual scale based on previous studies [4,20,21] was used to score the degree of parenchymal abnormality in the upper, mid and lower zone of each lung (05 ,5%, 155-25%, 2526-50%, 3551-75% and 4576-100%) for both emphysema and fibrosis. In order to assess the distribution of parenchymal disease on HRCT for the purpose of this study, the sum of the right and left upper zone scores was compared to the sum of the right and left lower zone scores for emphysema and fibrosis, respectively.…”

Section: Methodsmentioning

confidence: 99%

Pulmonary hypertension in COPD: results from the ASPIRE registry

et al. 2012

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The phenotype and outcome of severe pulmonary hypertension in chronic obstructive pulmonary disease (COPD) is described in small numbers, and predictors of survival are unknown. Data was retrieved for 101 consecutive, treatment-naïve cases of pulmonary hypertension in COPD.Mean¡SD follow-up was 2.3¡1.9 years. 59 patients with COPD and severe pulmonary hypertension, defined by catheter mean pulmonary artery pressure o40 mmHg, had significantly lower carbon monoxide diffusion, less severe airflow obstruction but not significantly different emphysema scores on computed tomography compared to 42 patients with mild-moderate pulmonary hypertension. 1-and 3-year survival for severe pulmonary hypertension, at 70% and 33%, respectively, was inferior to 83% and 55%, respectively, for mild-moderate pulmonary hypertension. Mixed venous oxygen saturation, carbon monoxide diffusion, World Health Organization functional class and age, but not severity of airflow obstruction, were independent predictors of outcome. Compassionate treatment with targeted therapies in 43 patients with severe pulmonary hypertension was not associated with a survival benefit, although improvement in functional class and/or fall in pulmonary vascular resistance .20% following treatment identified patients with improved survival.Standard prognostic markers in COPD have limited value in patients with pulmonary hypertension. This study identifies variables that predict outcome in this phenotype. Despite poor prognosis, our data suggest that further evaluation of targeted therapies is warranted.

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Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring.

Cited by 422 publications

References 22 publications

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis

Pulmonary hypertension in COPD: results from the ASPIRE registry

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