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

Narufumi Suganuma; Yukinori Kusaka; Kurt G. Hering; Tapio Vehmas; Thomas Kraus; Hiroaki Arakawa; John E. Parker; Leena Kivisaari; Marc Letourneux; Pierre A. Gevenois; Siegfreud Tuengerthal; Michael D. Crane; Hisao Shida; Masanori Akira; Daniel A. Henry; Yasuo Nakajima; Yohmei Hiraga; Harumi Itoh; Yutaka Hosoda

doi:10.1539/joh.L8030

Original

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

Narufumi Suganuma, Yukinori Kusaka, Kurt G. Hering, Tapio Vehmas, Thomas Kraus, Hiroaki Arakawa, John E. Parker, Leena Kivisaari, Marc Letourneux, Pierre A. Gevenois, Siegfreud Tuengerthal, Michael D. Crane, Hisao Shida, Masanori Akira, Daniel A. Henry, Yasuo Nakajima, Yohmei Hiraga, Harumi Itoh, Yutaka Hosoda

Author information

Narufumi Suganuma
Department of Environmental Medicine, Kochi Medical School
Yukinori Kusaka
Division of Environmental Health, Department of International and Social Medicine, School of Medicine, University of Fukui
Kurt G. Hering
Department of Diagnostic Radiology, Radiooncology and Nuclear Medicine, Knappschaftskrankenhaus
Tapio Vehmas
Department of Radiology, Finnish Institute of Occupational Health
Thomas Kraus
Institute and Outpatient Clinic for Occupational Medicine, Aachen University of Technology
Hiroaki Arakawa
Department of Radiology, Dokkyo Medical University
John E. Parker
West Virginia University School of Medicine
Leena Kivisaari
Department of Radiology, Helsinki University School of Medicine
Marc Letourneux
Service de Médicine du Travail et Pathologie Professionnelle
Pierre A. Gevenois
Department of Radiology, Hospital Erasme-Universite Libre de Bruxelles
Siegfreud Tuengerthal
The Clinic for Thoracic Diseases, Radiology and Nuclear Medicine
Michael D. Crane
Radiology Department, Llandough Hospital
Hisao Shida
Rosai Hospital for Silicosis
Masanori Akira
Department of Radiology, NHO-Kinki Chuo Chest Medical Center
Daniel A. Henry
Department of Radiology, Medical College of Virginia Hospitals, School of Medicine, Virginia Commonwealth University
Yasuo Nakajima
Department of Radiology, St. Marianna University School of Medicine
Yohmei Hiraga
Sapporo Railway Hospital
Harumi Itoh
University of Fukui
Yutaka Hosoda
Radiation Effects Research Foundation

Keywords: Classification, Computed tomography (CT), Lung diseases, Occupational and environmental diseases, Pleura diseases, Thin section

JOURNAL FREE ACCESS

2009 Volume 51 Issue 3 Pages 210-222

DOI https://doi.org/10.1539/joh.L8030

View "Advance Publication" version (April 17, 2009).

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Abstract

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 κ=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 κ=0.52-0.80) for parenchymal findings, but the agreement was relatively low (mean weighted κ=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.

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