Idiopathic interstitial pneumonias: Diagnostic accuracy of thin-section CT in 129 patients

Takeshi Johkoh, Nestor L. Müller, Yannick Cartier, Peter V. Kavanagh, Thomas E. Hartman, Masanori Akira, Kazuya Ichikado, Masayuki Ando, Hironobu Nakamura

Research output: Contribution to journalArticle

278 Scopus citations

Abstract

PURPOSE: To determine whether idiopathic interstitial pneumonias can be differentiated on the basis of the pattern and distribution of abnormalities at thin-section computed tomography (CT). MATERIALS AND METHODS: Thin- section CT scans in 129 patients with histologically proved idiopathic interstitial pneumonia (35 with usual interstitial pneumonia [UIP], 24 with bronchiolitis obliterans organizing pneumonia [BOOP], 23 with desquamative interstitial pneumonia [DIP], 20 with acute interstitial pneumonia [AIP], and 27 with nonspecific interstitial pneumonia and fibrosis [NIPF] were independently assessed by two observers without knowledge of clinical or histologic data. The observers recorded the abnormalities, diagnosis, and degree of confidence in their diagnosis. Differential diagnosis was limited to the five types of idiopathic interstitial pneumonia. RESULTS: The two observers made a correct diagnosis, on average, in 74 (57%) cases. On average, the correct diagnosis was made in 25 (71%) cases of UIP, 19 (79%) of BOOP, 14.5 (63%) of DIP, 13 (65%) of AIP, and 2.5 (9%) of NIPF. The two observers made a correct diagnosis with a high degree of confidence in 50 (39%) readings. There was moderate agreement between the observers for the correct diagnosis (κ = 0.55) and for the correct diagnosis with a high degree of confidence (κ = 0.65). CONCLUSION: Except for NIPF, the various subtypes of idiopathic interstitial pneumonias often have a characteristic appearance that allows differentiation at thin-section CT.

Original languageEnglish (US)
Pages (from-to)555-560
Number of pages6
JournalRadiology
Volume211
Issue number2
DOIs
StatePublished - May 1999

Keywords

  • Bronchiolitis obliterans organizing pneumonia
  • Lung, CT
  • Pneumonia, acute interstitial
  • Pneumonia, desquamative interstitial
  • Pneumonia, nonspecific interstitial and fibrosis
  • Pneumonia, usual interstitial

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Johkoh, T., Müller, N. L., Cartier, Y., Kavanagh, P. V., Hartman, T. E., Akira, M., Ichikado, K., Ando, M., & Nakamura, H. (1999). Idiopathic interstitial pneumonias: Diagnostic accuracy of thin-section CT in 129 patients. Radiology, 211(2), 555-560. https://doi.org/10.1148/radiology.211.2.r99ma01555