title: Development of a guideline on reading CT images of malignant pleural mesothelioma and selection of the reference CT films.
abstract: OBJECTIVE
  International experts developed a guideline on reading CT images of malignant pleural mesothelioma for radiologists and physicians. It is intended that it act as a supplement to the current International Classification of HRCT for Occupational and Environmental Respiratory Diseases.
  
  
  METHODS
  The research literatures on mesothelioma CT features were systematically reviewed. Ten mesothelioma CT features were adopted into the guideline prepared according to experts' opinion. The terminology of mesothelioma CT features and mesothelioma probability were agreed by consensus of experts. The CT reference films for each mesothelioma feature were selected based on agreement by experts from 22 definite mesothelioma cases confirmed pathologically and immunohistochemically. To support the validity of the mesothelioma probability, 4 experts' readings of CT films from 57 cases with or without mesothelioma were analyzed by kappa statistics between the experts; sensitivity and specificity for mesothelioma were also assessed.
  
  
  RESULTS
  The mesothelioma CT Guideline was developed, providing the terminology of CT features and the mesothelioma probability, the judgement of severity, the distribution of mesothelioma, and the revised CT reading sheet including mesothelioma items. The CT reference films with ten mesothelioma typical features were selected. The average linearly and quadratically weighted kappa of the agreement on the 4-point scale mesothelioma probability were 0.58 and 0.71, respectively. The average sensitivity and specificity for mesothelioma were 93.2% and 65.6%, respectively.
  
  
  CONCLUSIONS
  The evidence-based mesothelioma CT Guideline developed may serve as a good educational tool to facilitate physicians in recognising mesothelioma and improve their proficiency in diagnosis of mesothelioma.
authors.affiliation: Department of Environmental Health, School of Medicine, University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture 910-1193, Japan. zhouhua@u-fukui.ac.jp
authors.forename: Huashi
authors.initials: H
authors.lastname: Zhou
authors.forename: Taro
authors.initials: T
authors.lastname: Tamura
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kusaka
authors.forename: Narufumi
authors.initials: N
authors.lastname: Suganuma
authors.forename: Ponglada
authors.initials: P
authors.lastname: Subhannachart
authors.forename: Chomphunut
authors.initials: C
authors.lastname: Vijitsanguan
authors.forename: Weeraya
authors.initials: W
authors.lastname: Noisiri
authors.forename: Kurt G
authors.initials: KG
authors.lastname: Hering
authors.forename: Masanori
authors.initials: M
authors.lastname: Akira
authors.forename: Harumi
authors.initials: H
authors.lastname: Itoh
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Arakawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Kumagai
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D006801:Humans; D038801:International Classification of Diseases / Q000592:standards*; D038622:Internationality; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008495:Medical Oncology / Q000592:standards*; D008654:Mesothelioma / Q000000981:diagnostic imaging*; D000086002:Mesothelioma, Malignant; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards*; D012016:Reference Values; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*