%0 Journal Article
%T A Validated Model for the Imaging Diagnosis of Cystic Lung Disease
%A Wallace T. Miller
%A Karen C. Patterson
%A Shweta Sood
%A James E. Schmitt
%A Arshad A. Wani
%A Robert Borden
%A Maya Galperin-Aisenberg
%A Mary K. Porteus
%A Michelle L. Hershman
%A Michael Hewitt
%A Jennifer Levy
%A Victor D. Babatunde
%A Tetiana Glushko
%A Timothy J. Niesen
%A Sergey Leshchinskiy
%A Karine Sahakyan
%A Keyur Desai
%A Jennifer A. Gillman
%A Sandeep Reddy
%A Michael Shriver
%A Nathaniel B. Linna
%A Abass M. Noor
%A Aysenur Buz
%A Matthew E. Biron
%A Scott Simpson
%J Open Journal of Radiology
%P 42-57
%@ 2164-3032
%D 2023
%I Scientific Research Publishing
%R 10.4236/ojrad.2023.131005
%X <strong>Rationale and Objectives</strong>: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists could perform similarly to specialist physicians in the diagnosis of cystic lung disease. <strong>Methods</strong>: 72 cystic lung disease cases and 25 cystic lung disease mimics were obtained from three sources: 1) a prospective acquired diffuse lung disease registry, 2) a retrospective search of medical records and 3) teaching files. Cases were anonymized, randomized and interpreted by 7 diffuse lung disease specialists and 15 non-specialist radiologists and pulmonologists. Clinical information other than age and sex was not provided. Prior to interpretation, non-specialists viewed a short PDF training document explaining cystic lung disease interpretation. <strong>Results</strong>: Correct first choice diagnosis of 85%-88% may be achieved by high-performing specialist readers and 71%-80% by non-specialists and lower-performing specialists, with mean accuracies in the diagnosis of LAM (91%, p &lt; 0.0001), BHD (93%, p &lt; 0.0001), PLCH (89%, p &lt; 0.0001) and LIP (92%, p &lt; 0.0001). A strategy based on cyst appearance: simple cysts (LAM), peri-septal cysts (BHD), bizarre-shaped cysts (PLCH) and vascular indented cysts (LIP) gave non-specialists accuracies of 90% (p &lt; 0.0001), 94% (p &lt; 0.0001), 92% (p &lt; 0.0001) and 88% (p &lt; 0.0001), respectively, for these diagnoses. Cystic lung abnormalities caused by diseases other than LAM, BHD, PLCH and LIP are rarely accurately diagnosed by imaging alone. <strong>Conclusion</strong>: With specific but limited training, non-specialist physicians can diagnose cystic lung diseases from CT appearance alone with similar accuracy to specialists, correctly identifying approximately 75% of cases.
%K Lymphangioleiomyomatosis
%K Histiocytosis
%K Langerhans-Cell
%K Idiopathic Interstitial Pneumonias
%K Birt-Hogg-Dube Syndrome
%K Lung Diseases
%K Interstitial
%K Diagnoses
%K Differential
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=123533