Lung (2014) 192:637–638 DOI 10.1007/s00408-014-9610-9
Pulmonologist Versus Radiologist Interpretation of Cystic Fibrosis on CT Imaging Don Hayes Jr. • Frederick R. Long • Nancy A. Ryan-Wenger • Shahid I. Sheikh
Received: 27 May 2014 / Accepted: 2 June 2014 / Published online: 22 June 2014 Ó Springer Science+Business Media New York 2014
To the Editor, A reproducible computed tomography (CT) scoring system exists that is used to evaluate the lobar location, severity, and extent of the broad spectrum of disease in cystic fibrosis (CF) [1]. Reviewing the current medical literature, studies using this scoring system primarily have radiologists scoring the CT scans [2, 3]. We were interested in seeing if pulmonologists could use this scoring system as effective as radiologists. Therefore, we had a pediatric pulmonologist and an adult pulmonologist provide scores using this accepted scoring system from ten patients with CF (22 ± 9 years of age, range 14–44 years) who had undergone two CT scans within 3 years of each other. A pediatric chest radiologist with extensive experience using the CT scoring system in CF also interpreted the same CT scans for the entire cohort. The scores from each CT scan (total of 20 scans)
were evaluated using bivariate Pearson correlation (r) between 3 raters. Table 1 provides the results with a significant correlation between the interpreting physicians. All 3 scorers underscored the scans, while scores from the pediatric pulmonologist were more correlated with the pediatric radiologist. The adult pulmonologist consistently scored the CT scans lower than the other two physicians, albeit still reaching significant correlation as determined by our analysis. We speculate that these differences in scoring were due to the adult physician seeing severe disease more commonly and thus underscoring the CT scan in comparison to the pediatric physicians. Based on the results of this brief study, pediatric and adult pulmonologists interpret CT scans in CF patients similarly as a pediatric chest radiologist with extensive experience. Future research can successfully be performed with either specialist interpreting CT scans.
D. Hayes Jr. S. I. Sheikh Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
F. R. Long Department of Radiology, The Ohio State University College of Medicine, Columbus, OH, USA
D. Hayes Jr. Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
F. R. Long Department of Radiology, Nationwide Children’s Hospital, Columbus, OH, USA
D. Hayes Jr. (&) S. I. Sheikh Section of Pulmonary Medicine, Nationwide Children’s Hospital, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA e-mail: [email protected]
N. A. Ryan-Wenger Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
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Table 1 The bivariate Pearson correlation (r) between three raters (pediatric pulmonologist (PP), adult pulmonologist (AP), and pediatric radiologist (PR)) of two computed tomography scans within three years of each other (N = 10) Condition
PP–PR
PP–AP
AP–PR
Bronchiectasis 1
0.999**
0.995**
0.994**
Bronchiectasis 2
0.990**
0.984**
0.967**
Mucus plugging 1
0.994**
0.985**
0.981**
Mucus plugging 2
0.811**
0.925**
0.635*
Airway trapping 1
0.982**
0.965**
0.957**
Airway trapping 2
0.982**
0.896**
0.838**
Parenchymal opacities 1
0.973**
0.843**
0.790**
Parenchymal opacities 2
0.957**
0.947**
0.813**
1 = first CT scan, 2 = second CT scan ** p \ 0.001, * p = 0.048 Acknowledgments The work and subsequent manuscript were completed at the Nationwide Children’s Hospital and The Ohio State University, Columbus, Ohio. The study was approved by the
123
Nationwide Children’s Hospital Institutional Review Board (IRB1200700). Conflict of interest
None.
References 1. Brody AS, Kosorok MR, Li Z, Broderick LS, Foster JL, Laxova A, Bandla H, Farrell PM (2006) Reproducibility of a scoring system for computed tomography scanning in cystic fibrosis. J Thorac Imaging 21(1):14–21 2. Simanovsky N, Cohen-Cymberknoh M, Shoseyov D, GilelesHillel A, Wilschanski M, Kerem E, Hiller N (2013) Differences in the pattern of structural abnormalities on CT scan in patients with cystic fibrosis and pancreatic sufficiency or insufficiency. Chest 144(1):208–214 3. Davis SD, Fordham LA, Brody AS, Noah TL, Retsch-Bogart GZ, Qaqish BF, Yankaskas BC, Johnson RC, Leigh MW (2007) Computed tomography reflects lower airway inflammation and tracks changes in early cystic fibrosis. Am J Respir Crit Care Med 175(9):943–950
Pulmonologist Versus Radiologist Interpretation of Cystic Fibrosis on CT Imaging Don Hayes Jr. • Frederick R. Long • Nancy A. Ryan-Wenger • Shahid I. Sheikh
Received: 27 May 2014 / Accepted: 2 June 2014 / Published online: 22 June 2014 Ó Springer Science+Business Media New York 2014
To the Editor, A reproducible computed tomography (CT) scoring system exists that is used to evaluate the lobar location, severity, and extent of the broad spectrum of disease in cystic fibrosis (CF) [1]. Reviewing the current medical literature, studies using this scoring system primarily have radiologists scoring the CT scans [2, 3]. We were interested in seeing if pulmonologists could use this scoring system as effective as radiologists. Therefore, we had a pediatric pulmonologist and an adult pulmonologist provide scores using this accepted scoring system from ten patients with CF (22 ± 9 years of age, range 14–44 years) who had undergone two CT scans within 3 years of each other. A pediatric chest radiologist with extensive experience using the CT scoring system in CF also interpreted the same CT scans for the entire cohort. The scores from each CT scan (total of 20 scans)
were evaluated using bivariate Pearson correlation (r) between 3 raters. Table 1 provides the results with a significant correlation between the interpreting physicians. All 3 scorers underscored the scans, while scores from the pediatric pulmonologist were more correlated with the pediatric radiologist. The adult pulmonologist consistently scored the CT scans lower than the other two physicians, albeit still reaching significant correlation as determined by our analysis. We speculate that these differences in scoring were due to the adult physician seeing severe disease more commonly and thus underscoring the CT scan in comparison to the pediatric physicians. Based on the results of this brief study, pediatric and adult pulmonologists interpret CT scans in CF patients similarly as a pediatric chest radiologist with extensive experience. Future research can successfully be performed with either specialist interpreting CT scans.
D. Hayes Jr. S. I. Sheikh Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
F. R. Long Department of Radiology, The Ohio State University College of Medicine, Columbus, OH, USA
D. Hayes Jr. Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
F. R. Long Department of Radiology, Nationwide Children’s Hospital, Columbus, OH, USA
D. Hayes Jr. (&) S. I. Sheikh Section of Pulmonary Medicine, Nationwide Children’s Hospital, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA e-mail: [email protected]
N. A. Ryan-Wenger Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
123
638
Lung (2014) 192:637–638
Table 1 The bivariate Pearson correlation (r) between three raters (pediatric pulmonologist (PP), adult pulmonologist (AP), and pediatric radiologist (PR)) of two computed tomography scans within three years of each other (N = 10) Condition
PP–PR
PP–AP
AP–PR
Bronchiectasis 1
0.999**
0.995**
0.994**
Bronchiectasis 2
0.990**
0.984**
0.967**
Mucus plugging 1
0.994**
0.985**
0.981**
Mucus plugging 2
0.811**
0.925**
0.635*
Airway trapping 1
0.982**
0.965**
0.957**
Airway trapping 2
0.982**
0.896**
0.838**
Parenchymal opacities 1
0.973**
0.843**
0.790**
Parenchymal opacities 2
0.957**
0.947**
0.813**
1 = first CT scan, 2 = second CT scan ** p \ 0.001, * p = 0.048 Acknowledgments The work and subsequent manuscript were completed at the Nationwide Children’s Hospital and The Ohio State University, Columbus, Ohio. The study was approved by the
123
Nationwide Children’s Hospital Institutional Review Board (IRB1200700). Conflict of interest
None.
References 1. Brody AS, Kosorok MR, Li Z, Broderick LS, Foster JL, Laxova A, Bandla H, Farrell PM (2006) Reproducibility of a scoring system for computed tomography scanning in cystic fibrosis. J Thorac Imaging 21(1):14–21 2. Simanovsky N, Cohen-Cymberknoh M, Shoseyov D, GilelesHillel A, Wilschanski M, Kerem E, Hiller N (2013) Differences in the pattern of structural abnormalities on CT scan in patients with cystic fibrosis and pancreatic sufficiency or insufficiency. Chest 144(1):208–214 3. Davis SD, Fordham LA, Brody AS, Noah TL, Retsch-Bogart GZ, Qaqish BF, Yankaskas BC, Johnson RC, Leigh MW (2007) Computed tomography reflects lower airway inflammation and tracks changes in early cystic fibrosis. Am J Respir Crit Care Med 175(9):943–950
