title: Inter- and intraobserver variation between radiologists in the detection of abnormal parenchymal lung changes on high-resolution computed tomography.
abstract: OBJECTIVE
  Radiological and histological evaluations are affected by subjective interpretation. This study determined the level of inter- and intraobserver variation among radiologists for detection of abnormal parenchymal lung changes on high resolution computed tomography (HRCT).
  
  
  METHODS
  HRCT images of 65 patients known to have systemic lupus erythematosus (with clinical pulmonary involvement) were retrospectively reviewed by four nonthoracic radiologists (two with expertise in magnetic resonance [MR] and two general radiologists). Each radiologist read the scans twice, with an interval between readings of at least 6 months. The interobserver variation among the first and second readings of the four radiologists and the intraobserver variation of each radiologist's two readings were assessed by the kappa statistic.
  
  
  RESULTS
  There was good agreement between the first and second readings of each radiologist. There was moderate agreement between the two readings of one MR radiologist (kappa=0.482); the other three radiologists had kappa values that were good to excellent (0.716, 0.691, and 0.829). There was a clinically acceptable level of interobserver variability between all radiologists. The agreement was fair to moderate between the MR radiologist and the other observers (kappa range: 0.362-0.519) and moderate to good between the other three radiologists (0.508-0.730).
  
  
  CONCLUSIONS
  The interpretation of imaging findings of abnormal parenchymal lung changes on HRCT is reproducible and the agreement between general radiologists is clinically acceptable. There is reduced agreement when the radiologist is not involved on a regular basis with thoracic imaging. Difficult or indeterminate cases may benefit from review by a chest radiologist.
authors.affiliation: Department of Clinical Radiology, Faculty of Medicine, Kuwait University, Kuwait. hkhawari@gmail.com
authors.forename: Hanaa
authors.initials: H
authors.lastname: Al-Khawari
authors.forename: Reji P
authors.initials: RP
authors.lastname: Athyal
authors.forename: Osama
authors.initials: O
authors.lastname: Al-Saeed
authors.forename: Prio N
authors.initials: PN
authors.lastname: Sada
authors.forename: Sana
authors.initials: S
authors.lastname: Al-Muthairi
authors.forename: Adel
authors.initials: A
authors.lastname: Al-Awadhi
mesh_terms: D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000473:pathology; D015588:Observer Variation; D011857:Radiographic Image Interpretation, Computer-Assisted; D011871:Radiology / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*