title: Inter-reader agreement in HRCT detection of pleural plaques and asbestosis in participants with previous occupational exposure to asbestos.
abstract: OBJECTIVE
  To investigate inter-reader agreement for the detection of pleural and parenchymal abnormalities using CT in a large cross-sectional study comprising information on individual cumulative exposure to asbestos.
  
  
  METHODS
  The project was approved by the hospital ethics committee, and all patients received information on the study and gave their written informed consent. In 5511 CT scans performed in a cohort of retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey programme (Asbestos Related Diseases Cohort, ARDCO), double randomised standardised readings, triple in case of disagreement, were performed by seven trained expert radiologists specialised in thoracic imaging and blind to the initial interpretation. Inter-reader agreement was evaluated by calculating the κ-weighted coefficient between pairs of expert readers and results of routine practice and final diagnosis after expert reading.
  
  
  RESULTS
  κ-Weighted coefficients between trained experts ranged from 0.28 to 0.52 (fair to good), 0.59 to 0.86 (good to excellent) and 0.11 to 0.66 (poor to good) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. κ-Weighted coefficients between results of routine practice and final diagnosis after expert reading were 0.13 (poor), 0.53 (moderate) and 0.11 (poor) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively.
  
  
  CONCLUSIONS
  Interpretation of benign asbestos-related thoracic abnormalities requires standardisation of the reading and trained readers, particularly for participants asking for compensation, and with a view to the longitudinal survey of asbestos-exposed workers.
authors.affiliation: Centre Cardiothoracique INSERM 1045, France Université de Bordeaux and CHU de Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Laurent
authors.affiliation: EA7298 Université de Lorraine, France Faculté de Médecine, and CHU Nancy, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Paris
authors.affiliation: INSERM U823, and Université J Fourrier, and Clinique universitaire de radiologie et imagerie médicale, CHU, Grenoble, France.
authors.forename: Gilbert R
authors.initials: GR
authors.lastname: Ferretti
authors.affiliation: Service de Radiologie Asssistance-Publique Hôpitaux de Paris, 47-83 Boulevard de l'hôpital, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Beigelman
authors.affiliation: Centre Cardiothoracique INSERM 1045, France Université de Bordeaux and CHU de Bordeaux, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Montaudon
authors.affiliation: Centre Cardiothoracique INSERM 1045, France Université de Bordeaux and CHU de Bordeaux, France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Latrabe
authors.affiliation: INSERM U823, and Université J Fourrier, and Clinique universitaire de radiologie et imagerie médicale, CHU, Grenoble, France.
authors.forename: A
authors.initials: A
authors.lastname: Jankowski
authors.affiliation: Service de Radiologie Asssistance-Publique Hôpitaux de Paris, 47-83 Boulevard de l'hôpital, Paris, France.
authors.forename: Yasmina
authors.initials: Y
authors.lastname: Badachi
authors.affiliation: Cancers et Populations INSERM U1086, France Service de Santé au Travail et Pathologie Professionnelle, Faculté de Médecine and CHU de Caen, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Clin
authors.affiliation: Service des Maladies Professionnelles, CHU Rouen, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Gislard
authors.affiliation: Cancers et Populations INSERM U1086, France Service de Santé au Travail et Pathologie Professionnelle, Faculté de Médecine and CHU de Caen, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Letourneux
authors.affiliation: EA7298 Université de Lorraine, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Luc
authors.affiliation: ERSM Rhône-Alpes, Lyon, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Schorlé
authors.affiliation: INSERM 897 and Université de Bordeaux, CHU de Bordeaux, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Brochard
authors.affiliation: Unité de Pathologie Professionnelle, Assistance-Publique Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ameille
authors.affiliation: Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Paris, France Service de Pneumologie et Pathologie Professionnelle, INSERM, U955 and Université Paris-Est Créteil, and Centre Hospitalier Intercommunal, Créteil, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Pairon
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000517:prevention & control*; D005355:Fibrosis; D006282:Health Personnel / Q000592:standards; D006801:Humans; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010994:Pleura / Q000000981:diagnostic imaging*; D010995:Pleural Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D001194:Asbestos