Inter-reader variability in chest radiography and HRCT for the early detection of asbestos-related lung and pleural abnormalities in a cohort of 636 asbestos-exposed subjects
Inter-reader variability in chest radiography and HRCT for the early detection of asbestos-related lung and pleural abnormalities in a cohort of 636 asbestos-exposed subjects
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DOI：
10.1007/s00420-009-0443-4
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发表时间：
2010-01-01
影响因子：
3
通讯作者：
Kraus, Thomas
中科院分区：
文献类型：
--
作者：
Ochsmann, Elke;Carl, Tanja;Kraus, Thomas
旨在比较过去 4 年期间曾接触过石棉的员工的胸部 X 光和高分辨率计算机断层扫描 (HRCT) 扫描的读者间差异。在这项纵向研究中，每年对 636 名曾经接触过石棉的人员进行胸部 X 光照片和 HRCT 扫描检查。十对观察者使用 ILO 分类和定制的 CT 分类对 X 光片和 HRCT 扫描进行分类。使用 kappa 系数计算观察者间变异性。尽管有各种预期，但根据早期石棉相关肺或胸膜改变的 HRCT 读取器间变异性并没有比 X 射线读取器间变异性更好。胸膜钙化的观察者间存在显着一致性（kappa（X 射线）= 0.63；kappa（CT）= 0.64）。对 kappa 进行平均可以使两种方法的观察者间达成公平的一致性（kappa（X 射线）= 0.36；kappa（CT）= 0.34）。高分辨率计算机断层扫描在检测石棉暴露后肺部变化方面优于 X 射线，并且据说更容易解释。然而，本研究中两种方法之间观察者间的变异性没有差异。这可能是由于该队列中唯一与石棉相关的肺部或胸膜改变，以及不熟悉的 CT 分类表（根据所提供的结果进行了修订）。
To compare inter-reader variability of chest X-ray and high resolution computed tomography (HRCT) scans of formerly asbestos-exposed employees over a 4-year period.In this longitudinal study, 636 formerly asbestos-exposed persons were annually examined with chest radiographs and HRCT scans. Ten observer pairs classified the radiographs and HRCT scans, using the ILO classification and a custom-made CT classification. Inter-observer variability was calculated using the kappa-coefficient.Despite all expectations, HRCT inter-reader variability according to asbestos-related lung or pleura alterations at an early stage did not turn out to be better than X-ray inter-reader variability. Substantial inter-observer agreement was found for pleural calcifications (kappa(X-ray) = 0.63; kappa(CT) = 0.64). Averaging over kappa led to fair inter-observer agreement of both methods (kappa(X-ray) = 0.36; kappa(CT) = 0.34).High resolution computed tomography scans are superior to X-rays in detecting lung alterations after asbestos exposure and are supposedly easier to interpret. Nevertheless, inter-observer variability did not differ between the two methods in this study. This was probably due to the only discrete asbestos-related lung or pleura alterations of this cohort and to the unfamiliar CT classification sheet, which was revised on the basis of the presented results.