4.1 Article

Reliability of the Proposed International Classification of High-Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases

期刊

JOURNAL OF OCCUPATIONAL HEALTH
卷 51, 期 3, 页码 210-222

出版社

JAPAN SOC OCCUPATIONAL HEALTH
DOI: 10.1539/joh.L8030

关键词

Classification; Computed tomography (CT); Lung diseases; Occupational and environmental diseases; Pleura diseases; Thin section

资金

  1. Ministry of Education, Culture, Sports, Science and Technology, Japan [11694258]
  2. Ministry of Education, Science, Culture, Sports, Science and Technology, Japan [13770189]
  3. Grants-in-Aid for Scientific Research [11694258, 13770189] Funding Source: KAKEN

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Reliability of the Proposed International Classification of High-Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases: Narufumi SUGANUMA, et al. Department of Environmental Medicine, Kochi Medical School-Purpose: We have developed a classification of high-resolution computed tomography (HRCT) images for screening, surveillance and epidemiological studies of respiratory diseases caused by occupational and environmental factors. The proposed classification consists of three parts: a guideline explaining the elements of the classification scheme, a reading sheet, and reference films to aid in assessing thin-section CT films. We assessed the reliability of the proposed classification system by blinded, independent trial reading. Materials and Methods: Seven independent radiologists and pulmonologists performed a trial reading to measure the reliability of the classification system using HRCT films from 27 pneumoconiosis patients and 7 normal controls. Results: The agreement was moderate to good for rounded opacities (weighted kappa=0.68 and 0.64), irregular opacities (0.59, 0.48), honeycombing (0.65, 0.47), emphysema (0.76, 0.62) and large opacities (0.48, 0.52). Ground glass opacities (0.16, 0.20) showed poor to fair agreement. Intra-reader agreement of each of the seven readers was moderate to good (mean: weighted kappa=0.52-0.80) for parenchymal findings, but the agreement was relatively low (mean weighted kappa=0.52) for ground glass opacities. Conclusion: The proposed classification is able to describe early dust-related fibrotic changes and provide a semi-quantitative description of the HRCT features of major fibrotic changes in the parenchyma and pleura. Reliability, as measured by inter-reader agreement, was satisfactory. (J Occup Health 2009; 51: 210-222)

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