TY - JOUR A1 - Voigt, Gesche M. A1 - Thiele, Dominik A1 - Wetzke, Martin A1 - Weidemann, Jürgen A1 - Parpatt, Patricia‐Maria A1 - Welte, Tobias A1 - Seidenberg, Jürgen A1 - Vogelberg, Christian A1 - Koster, Holger A1 - Rohde, Gernot G. U. A1 - Härtel, Christoph A1 - Hansen, Gesine A1 - Kopp, Matthias V. T1 - Interobserver agreement in interpretation of chest radiographs for pediatric community acquired pneumonia: Findings of the pedCAPNETZ‐cohort JF - Pediatric Pulmonology N2 - Although chest radiograph (CXR) is commonly used in diagnosing pediatric community acquired pneumonia (pCAP), limited data on interobserver agreement among radiologists exist. PedCAPNETZ is a prospective, observational, and multicenter study on pCAP. N = 233 CXR from patients with clinical diagnosis of pCAP were retrieved and n = 12 CXR without pathological findings were added. All CXR were interpreted by a radiologist at the site of recruitment and by two external, blinded pediatric radiologists. To evaluate interobserver agreement, the reporting of presence or absence of pCAP in CXR was analyzed, and prevalence and bias‐adjusted kappa (PABAK) statistical testing was applied. Overall, n = 190 (82%) of CXR were confirmed as pCAP by two external pediatric radiologists. Compared with patients with pCAP negative CXR, patients with CXR‐confirmed pCAP displayed higher C‐reactive protein levels and a longer duration of symptoms before enrollment (p < .007). Further parameters, that is, age, respiratory rate, and oxygen saturation showed no significant difference. The interobserver agreement between the onsite radiologists and each of the two independent pediatric radiologists for the presence of pCAP was poor to fair (69%; PABAK = 0.39% and 76%; PABAK = 0.53, respectively). The concordance between the external radiologists was fair (81%; PABAK = 0.62). With regard to typical CXR findings for pCAP, chance corrected interrater agreement was highest for pleural effusions, infiltrates, and consolidations and lowest for interstitial patterns and peribronchial thickening. Our data show a poor interobserver agreement in the CXR‐based diagnosis of pCAP and emphasized the need for harmonized interpretation standards. KW - antibiotic therapy KW - imaging KW - infections: pneumonia KW - TB KW - viral Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244705 VL - 56 IS - 8 SP - 2676 EP - 2685 ER - TY - JOUR A1 - Kaireit, Till F. A1 - Sorrentino, Sajoscha A. A1 - Renne, Julius A1 - Schoenfeld, Christian A1 - Voskrebenzev, Andreas A1 - Gutberlet, Marcel A1 - Schulz, Angela A1 - Jakob, Peter M. A1 - Hansen, Gesine A1 - Wacker, Frank A1 - Welte, Tobias A1 - Tümmler, Burkhard A1 - Vogel-Claussen, Jens T1 - Functional lung MRI for regional monitoring of patients with cystic fibrosis JF - PLoS ONE N2 - Purpose To test quantitative functional lung MRI techniques in young adults with cystic fibrosis (CF) compared to healthy volunteers and to monitor immediate treatment effects of a single inhalation of hypertonic saline in comparison to clinical routine pulmonary function tests. Materials and methods Sixteen clinically stable CF patients and 12 healthy volunteers prospectively underwent two functional lung MRI scans and pulmonary function tests before and 2h after a single treatment of inhaled hypertonic saline or without any treatment. MRI-derived oxygen enhanced T1 relaxation measurements, fractional ventilation, first-pass perfusion parameters and a morpho-functional CF-MRI score were acquired. Results Compared to healthy controls functional lung MRI detected and quantified significantly increased ventilation heterogeneity in CF patients. Regional functional lung MRI measures of ventilation and perfusion as well as the CF-MRI score and pulmonary function tests could not detect a significant treatment effect two hours after a single treatment with hypertonic saline in young adults with CF (p>0.05). Conclusion This study shows the feasibility of functional lung MRI as a non-invasive, radiation-free tool for monitoring patients with CF. KW - Physics KW - Magnetic resonance imaging KW - Functional magnetic resonance imaging KW - Cystic fibrosis KW - Oxygen KW - Pulmonary imaging KW - Hypertonic KW - Pulmonary function KW - Quantum chronodynamics Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-172457 VL - 12 IS - 12 ER -