دورية أكاديمية
Hypersensitivity Pneumonitis on Thin-Section Chest CT Scans: Diagnostic Performance of the ATS/JRS/ALAT versus ACCP Imaging Guidelines.
| العنوان: | Hypersensitivity Pneumonitis on Thin-Section Chest CT Scans: Diagnostic Performance of the ATS/JRS/ALAT versus ACCP Imaging Guidelines. |
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| المؤلفون: | Chelala L; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Adegunsoye A; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Strek M; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Lee CT; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Jablonski R; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Husain AN; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Udofia I; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637., Chung JH; From the Department of Cardiopulmonary Imaging (L.C., J.H.C.), Department of Medicine, Section of Pulmonary & Critical Care (A.A., M.S., C.T.L., R.J., I.U.), and Department of Pathology (A.N.H.), University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637. |
| المصدر: | Radiology. Cardiothoracic imaging [Radiol Cardiothorac Imaging] 2024 Aug; Vol. 6 (4), pp. e230068. |
| نوع المنشور: | Journal Article; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Radiological Society of North America, Inc Country of Publication: United States NLM ID: 101748663 Publication Model: Print Cited Medium: Internet ISSN: 2638-6135 (Electronic) Linking ISSN: 26386135 NLM ISO Abbreviation: Radiol Cardiothorac Imaging Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oak Brook, IL : Radiological Society of North America, Inc., [2019]- |
| مواضيع طبية MeSH: | Alveolitis, Extrinsic Allergic*/diagnostic imaging , Alveolitis, Extrinsic Allergic*/diagnosis , Alveolitis, Extrinsic Allergic*/epidemiology , Tomography, X-Ray Computed*/methods, Humans ; Female ; Male ; Retrospective Studies ; Middle Aged ; Aged ; Practice Guidelines as Topic/standards ; Lung/diagnostic imaging ; Sensitivity and Specificity ; Societies, Medical ; United States/epidemiology |
| مستخلص: | Purpose To compare the diagnostic performance of the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax (ATS/JRS/ALAT) versus the American College of Chest Physicians (ACCP) imaging classifications for hypersensitivity pneumonitis (HP). Materials and Methods Patients in the institutional review board-approved Interstitial Lung Disease (ILD) registry referred for multidisciplinary discussion (MDD) at the authors' institution (January 1, 2006-April 1, 2021) were included in this retrospective study when ILD was diagnosed at MDD. MDD diagnoses included HP, connective tissue disease-ILD, and idiopathic pulmonary fibrosis. Retrospective review of thin-section CT images was performed in consensus by two cardiothoracic radiologists blinded to the diagnosis. Diagnostic patterns were determined for thin-section CT images using both classifications. Discordance rates were determined. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were assessed using MDD diagnosis as the reference standard. Results A total of 297 patients were included in the study: 200 (67%) with HP, 49 (16%) with connective tissue disease-ILD, and 48 (16%) with idiopathic pulmonary fibrosis at MDD. The discordance rate between the two classifications was 21%. Assuming low HP prevalence (10%), ATS/JRS/ALAT classification outperformed ACCP classification, with greater accuracy (92.3% vs 87.6%) and greater positive predictive value (60.7% vs 42.9%). Assuming high prevalence (50%), accuracy and negative predictive value were superior using ACCP classification (81.7% vs 79.7% and 77.7% vs 72.6%, respectively), and positive predictive value was superior using ATS/JRS/ALAT classification (93.3% vs 87.1%). Conclusion Accuracy of the ATS/JRS/ALAT and ACCP HP classifications was greater in settings with low and high HP prevalence, respectively. Diagnostic performance of both classifications was discordant in a minority of cases. Keywords: CT, Thorax, Hypersensitivity Pneumonitis, Interstitial Lung Disease Supplemental material is available for this article. © RSNA, 2024. |
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| فهرسة مساهمة: | Keywords: CT; Hypersensitivity Pneumonitis; Interstitial Lung Disease; Thorax |
| تواريخ الأحداث: | Date Created: 20240711 Date Completed: 20240711 Latest Revision: 20240904 |
| رمز التحديث: | 20240904 |
| DOI: | 10.1148/ryct.230068 |
| PMID: | 38990131 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2638-6135 |
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| DOI: | 10.1148/ryct.230068 |