- Email: [email protected]
120 Teleradiology in interstitial lung disease: first experiences
Oral Sessions Session 19: Free Communications - Interstitial lung disease, translational research and pulmonary hypertension
120 Teleradiology in interstitial lung disease: first experiences K.E. Hostettler1, G. Sommer2, M. Tamm1, J. Bremerich2 1 Clinics of Respiratory Medicine, 2Department of Radiology, University Hospital Basel, Basel, Switzerland Introduction: High resolution computed tomography (HRCT) is an essential component of the diagnostic algorithm for idiopathic pulmonary fibrosis (IPF). In the absence of an identifiable cause of interstitial lung disease (ILD), an HRCT showing a typical usual interstitial pneumonia (UIP) pattern is diagnostic for IPF. However, it might be difficult to identify a typical UIP pattern, specifically if there is no access to a specialized thorax radiologist experienced in ILD. Here we report first experiences with a teleradiology-project that offers the possibility for second opinion HRCT read for patients with suspected IPF. Methods: Physicians caring for patients with suspected IPF were given the possibility to send HRCTs for a second opinion regarding the presence of UIP pattern. HRCT were uploaded through a secured internet connection. Only images in original Digital Imaging and Communication in Medicine (DICOM) format were accepted to provide uncompressed full digital information of all HRCT images. HRCTs were assessed by a radiologist and a pulmonologist, both experienced in the diagnosis of ILD. The HRCT criteria for UIP pattern were applied according to the current guidelines: features necessary for the diagnosis of a typical UIP pattern were: i) subpleural and basal predominance, ii) reticular abnormality, iii) honeycombing tractionbronchiectasis, and iv) absence of features inconsistent with UIP pattern. Each HRCT was rated showing either a) typical UIP pattern, b) possible UIP pattern, or c) being inconsistent with UIP pattern. Results: Between March 2015 and January 2017 we received 160 HRCTs for a second opinion read from physicians in 10 different Eastern European countries. All images were of diagnostic quality. In 58/160 (36%) patients a typical UIP pattern was diagnosed, possible UIP pattern was detected in 27/160 (17%) patients, and in 75/160 (47%) patients the prevailing pattern was considered as inconsistent with UIP.
DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.018
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
journal.publications.chestnet.org
17A
ORAL SESSIONS
Conclusions: Our data demonstrate a useful application of teleradiology to provide expert reading of HRCT in patients with suspected IPF, particularly when local radiological expertise for reading ILD chest CT is limited. This project is not intended to replace local multidisciplinary panels, but to support local panels by providing specific expertise and standardised reading of chest CT in accordance to specific guidelines. More experience will be needed to define the role of teleradiology in patients with suspected IPF.
120 Teleradiology in interstitial lung disease: first experiences K.E. Hostettler1, G. Sommer2, M. Tamm1, J. Bremerich2 1 Clinics of Respiratory Medicine, 2Department of Radiology, University Hospital Basel, Basel, Switzerland Introduction: High resolution computed tomography (HRCT) is an essential component of the diagnostic algorithm for idiopathic pulmonary fibrosis (IPF). In the absence of an identifiable cause of interstitial lung disease (ILD), an HRCT showing a typical usual interstitial pneumonia (UIP) pattern is diagnostic for IPF. However, it might be difficult to identify a typical UIP pattern, specifically if there is no access to a specialized thorax radiologist experienced in ILD. Here we report first experiences with a teleradiology-project that offers the possibility for second opinion HRCT read for patients with suspected IPF. Methods: Physicians caring for patients with suspected IPF were given the possibility to send HRCTs for a second opinion regarding the presence of UIP pattern. HRCT were uploaded through a secured internet connection. Only images in original Digital Imaging and Communication in Medicine (DICOM) format were accepted to provide uncompressed full digital information of all HRCT images. HRCTs were assessed by a radiologist and a pulmonologist, both experienced in the diagnosis of ILD. The HRCT criteria for UIP pattern were applied according to the current guidelines: features necessary for the diagnosis of a typical UIP pattern were: i) subpleural and basal predominance, ii) reticular abnormality, iii) honeycombing tractionbronchiectasis, and iv) absence of features inconsistent with UIP pattern. Each HRCT was rated showing either a) typical UIP pattern, b) possible UIP pattern, or c) being inconsistent with UIP pattern. Results: Between March 2015 and January 2017 we received 160 HRCTs for a second opinion read from physicians in 10 different Eastern European countries. All images were of diagnostic quality. In 58/160 (36%) patients a typical UIP pattern was diagnosed, possible UIP pattern was detected in 27/160 (17%) patients, and in 75/160 (47%) patients the prevailing pattern was considered as inconsistent with UIP.
DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.018
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
journal.publications.chestnet.org
17A
ORAL SESSIONS
Conclusions: Our data demonstrate a useful application of teleradiology to provide expert reading of HRCT in patients with suspected IPF, particularly when local radiological expertise for reading ILD chest CT is limited. This project is not intended to replace local multidisciplinary panels, but to support local panels by providing specific expertise and standardised reading of chest CT in accordance to specific guidelines. More experience will be needed to define the role of teleradiology in patients with suspected IPF.