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.

中文翻译：

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使用高分辨率 CT 评估间质性肺病的观察者间一致性的荟萃分析。


背景 高分辨率 CT （HRCT） 是评估间质性肺病 （ILD） 的核心，准确分类疾病对患者具有重要意义。即使对于经验丰富的胸部放射科医生来说，影像学特征的评估也可能具有挑战性。以前的工作为 ILD 相关成像中 HRCT 特征的解释提供了模棱两可的证据。目的 进行荟萃分析以评估胸部放射学专家在解释 ILD 相关成像方面的一致性水平。材料和方法 从 2000 年 1 月至 2023 年 10 月对 Ovid MEDLINE、Embase 和 Cochrane 对照试验中心注册库数据库进行了系统文献检索，以查找报告胸部放射科医生之间评估观察者间一致性以评估 ILD 结果的文章，例如疾病的严重程度和进展，存在蜂窝状和磨玻璃样混浊等特征， 以及基于 2011 年和 2018 年美国胸科学会/欧洲呼吸学会/日本呼吸学会/拉丁美洲托拉克斯协会 （ATS/ERS/JRS/ALAT） 特发性肺纤维化 （IPF） 指南的分类。使用随机效应模型进行 meta 分析，以获得合并的 κ 或类内相关系数 （ICC） 值作为观察者间一致性的度量。结果 最终分析包括 13 项研究，包括 6943 张图像和 146 名放射科医生。在评估 ILD 中特异性放射学检查结果一致性的 10 项研究中，合并 κ 值为 0.56 （95% CI： 0.43， 0.70）。在 8 项研究中，基于通常间质性肺炎 （UIP） 模式的 ATS/ERS/JRS/ALAT 诊断指南的观察者间一致性评估，合并 κ 值为 0.61 （95% CI： 0.48， 0.74）。 一项研究报告了 ILD 进展的 κ 值为 0.87。无法合并 7 项评估 ILD 严重程度的研究;ILD 严重程度的单个 κ 值范围为 0.64 至 0.90，ICC 值范围为 0.63 至 0.96。结论 在评估 ILD 特征和 UIP 模式诊断时，胸部放射科医生之间有中等一致性，但几乎没有证据表明疾病严重程度、范围或进展的一致性。荟萃分析登记编号PROSPERO CRD42022361803 © RSNA， 2024 本文提供补充材料。另请参见 Humbert 在本期的社论。