Extension of Pulmonary Fibrosing Diseases: a Comparison of Quantification Scoring Systems

OBJECTIVES To compare interobserver variability of main visual scoring systems for the quanti cation of global extension of pulmonary interstitial disease among new method of scoring based on HRCT coronal images; de ne which of these scores better correlates with functional de cit. MATERIAlS AND METHDS Study population was constituted by 39 patient affected by ILD (20 UIP, 14 NSIP, 4 CPFE and 1 CHP) who underwent both HRCT and PFT. HRCT images were assessed regardless of two trainee radiologists using three different methods of visual scoring: 1) on ve HRCT images at pre-established levels; 2) on three lung zones through “scrolling” of HRCT images; 3) on six HRCT images reformatted for coronal reconstructions. We compared the levels of interobserver variation for each visual scoring method through Bland-Altman test. In addition, we compared correlation between DLco and visual scores obtained with these three different methods. RESULTS The 95% LoA of ILD extent between observer 1 and 2 for visual scoring method 1, 2 and 3 were respec- tively -35.2% to 20%, -38.8% to 17.4%, -41.3% to 24.9%. Method 1 had a fair correlation (r = -0.3, p = 0.05) between averaged observers’ scores and DLco. Method 2 reported the lowest correlation (r = -0.2, p = 0.2), while the greatest one was observed for method 3 (r = -0.4, p = 0.03). CONCLUSIONS Despite the visual scoring method based on HRCT coronal images showed the greatest interobserver vari- ability, its use improved correlations between ILD extent on HRCT and DLco.