Concordance of High-Resolution Ct Pattern Classification with Multidisciplinary Diagnosis in Suspected Interstitial Lung Disease: A Retrospective Study

Ashok Kattimani; Shivasharanappa Akka; Shivraj Biradar; Shravil Shravil

doi:10.37022/wjcmpr.v8i3.455

Authors

Ashok Kattimani Associate professor, Department of Radiology, Bidar Institute of Medical Sciences.
Shivasharanappa Akka Assistant Professor, Department of Radiology, Bidar Institute of Medical Sciences.
Shivraj Biradar Associate Professor, Department of Medicine, Bidar Institute of Medical Sciences.
Shravil Senior Resident, Department of Radiology, Bidar Institute of Medical Sciences.

Abstract

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of diffuse parenchymal lung disorders with variable inflammatory and fibrotic components. Overlapping clinical and radiological features make diagnosis challenging, and high-resolution computed tomography (HRCT) is central to the imaging assessment of suspected ILD.
Objective: To describe the distribution of HRCT patterns in patients with suspected ILD and to assess their concordance with the final multidisciplinary discussion (MDD) diagnosis.
Methods: This retrospective single-centre study included 52 patients with suspected ILD who underwent HRCT between January 2023 and June 2023. Two thoracic radiologists independently classified HRCT patterns using the 2018 ATS/ERS/JRS/ALAT framework. Concordance with the final MDD diagnosis was calculated as a proportion with 95% confidence intervals (CIs), and interobserver agreement was assessed with Cohen's kappa.
Results: The mean age was 61.8 ± 12.3 years, and 30 patients (57.7%) were male. Definite usual interstitial pneumonia (UIP) was the most frequent HRCT pattern (20 patients, 38.5%), followed by nonspecific interstitial pneumonia (NSIP; 12, 23.1%), hypersensitivity pneumonitis (HP; 6, 11.5%), organizing pneumonia (OP; 6, 11.5%), sarcoidosis (5, 9.6%), and other patterns (3, 5.8%). Overall HRCT–MDD concordance was 82.7% (43/52; 95% CI 70.3–90.6%), including 95.0% (19/20; 95% CI 76.4–99.1%) for definite UIP and 75.0% (24/32; 95% CI 57.9–86.7%) for non-UIP patterns. Interobserver agreement was κ = 0.79 (95% CI 0.68–0.90). Nine cases (17.3%) were discordant.
Conclusion: HRCT pattern classification showed 82.7% concordance with the final MDD diagnosis, with higher concordance for definite UIP than for non-UIP patterns. Because MDD incorporates imaging, these results describe agreement rather than independent diagnostic accuracy. HRCT should be interpreted within an integrated clinical and multidisciplinary assessment.

Keywords:

high-resolution computed tomography, interstitial lung disease, usual interstitial pneumonia, idiopathic pulmonary fibrosis, multidisciplinary discussion, concordance

DOI

https://doi.org/10.37022/wjcmpr.v8i3.455

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