Selection of reference films based on reliability assessment of a classification of high-resolution computed tomography for pneumoconioses
Selection of reference films based on reliability assessment of a classification of high-resolution computed tomography for pneumoconioses
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DOI：
10.1007/s00420-005-0067-2
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发表时间：
2006-06-01
影响因子：
3
通讯作者：
Shida, Hisao
中科院分区：
文献类型：
--
作者：
Suganuma, Narufumi;Kusaka, Yukinori;Shida, Hisao
目标：全世界对开发计算机断层扫描 (CT) 分类系统的需求有所增加，以补充 ILO 尘肺病 X 线照片分类。作者旨在展示由七个国家的研究人员共同努力开发的 CT 分类系统的选定参考胶片的初步可靠性测试结果。方法：由 8 名具有丰富尘肺病治疗经验的医生对粉尘暴露工人的 19 张 CT 片中的 6 个肺区组成的 114 个肺区进行阅读试验，以评估加权 kappa 分类系统的可靠性。结果还用于选择参考电影。结果：对于圆形混浊（加权 kappa = 0.76、0.74，分别为第一次和第二次试验结果）、不规则混浊（0.60、0.48）、肺气肿（0.56、0.70）和蜂窝状混浊（0.72、0.79），第一次和第二次读取试验观察到良好的一致性。另一方面，毛玻璃混浊表现出中等程度的一致性（0.43，0.38）。八名读者之间的读者内协议显示在同一张表中，作为加权 kappa 统计的平均值和标准差。读者间对胸膜增厚的共识不如对实质病变的共识。讨论：CT 分类的发展可能会在特定环境中为接触粉尘的工人提供高尚且敏感的医疗筛查。该系统可应用于国际劳工组织分类中大量 0/1 和 1/0 的射线照相边界病例，确保接触某些新开发的化合物的工人的职业安全和健康。
Objective: Worldwide demand has increased for the development of a computed tomography (CT) classification system that supplements the ILO classification of radiographs for pneumoconioses. The authors aimed to show preliminary reliability test results for selected referent films for the CT classification system developed through an international effort by researchers from seven countries. Methods: Reading trials by eight physicians who have considerable experience in pneumoconioses using a total of 114 lung zones consisting of 6 lung zones of 19 CT films of dust-exposed workers were performed to assess reliability of the classification system by weighted kappa. The results were also utilized for selecting reference films. Results: A good agreement was observed for both first and second reading trials for rounded opacities (weighted kappa=0.76, 0.74, first and second trial results, respectively), irregular opacities (0.60, 0.48), emphysema (0.56, 0.70) and honeycombing (0.72, 0.79). Ground glass opacities, on the other hand, showed moderate agreement (0.43, 0.38). Intra-reader agreements among eight readers were shown in the same table as the mean and standard deviation of weighted kappa statistics. The inter-reader agreement for pleural thickening was not as good as for parenchymal lesions. Discussion: The CT classification development may pioneer noble and sensitive medical screening for dust-exposed workers in selected settings. This system may be applied to radiographic borderline cases of profusion 0/1 and 1/0 by the ILO classification, in a setting that assures the occupational safety and health of workers exposed to some newly developed chemical compounds.