End-stage lung disease: CT findings in 61 patients.
OBJECTIVE
To determine whether the cause of end-stage lung disease could be determined on the basis of pattern and distribution of abnormalities at computed tomography (CT).


METHODS
The CT scans from 61 consecutive patients with end-stage lung disease were independently assessed by two observers without knowledge of clinical or pathologic data. End-stage lung disease was defined by the presence of honeycombing, extensive cystic changes, or conglomerate fibrosis. The observers listed the three most likely diagnoses and recorded the degree of confidence in the first-choice diagnosis on a three-point scale.


RESULTS
The observers made a correct first-choice diagnosis in an average of 87% of cases. A correct first-choice diagnosis was made most often in silicosis (100%), Langerhans cell histiocytosis (100%), asbestosis (90%), usual interstitial pneumonia (88%), extrinsic allergic alveolitis (87%), and sarcoidosis (83%). There was good agreement between the two observers on the first-choice diagnosis (kappa statistic, 0.89).


CONCLUSIONS
The pattern and distribution of abnormalities in end-stage lung disease are determined by the underlying cause. In most cases, a specific diagnosis can be made on the basis of the CT findings.
Primack
S L
SL
Department of Radiology, University of British Columbia, Vancouver, Canada.
Hartman
T E
TE
Hansell
D M
DM
Müller
N L
NL
D000542:Alveolitis, Extrinsic Allergic / Q000000981:diagnostic imaging; D001195:Asbestosis / Q000000981:diagnostic imaging; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000000981:diagnostic imaging; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017565:Sarcoidosis, Pulmonary / Q000000981:diagnostic imaging; D012829:Silicosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*