Diagnosis of IPA in HIV: the role of the chest X-ray and radiologist
| Autor: | Patricia Ribaud, Raoul Herbrecht, Olivier Lortholary, Joerg W. Oestmann, Klaus Neumann, R Röttgen, David W. Denning, Markus Ruhnke, Uta Zaspel, Georg Maschmeyer, Klaus F. Rabe, Dirk Schürmann, Harmien Zonderland, Reginald Greene, Roland Bittner, Arne Lemke |
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| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
Human immunodeficiency virus (HIV) HIV Infections Aspergillosis medicine.disease_cause Diagnosis Differential Germany medicine Humans False Positive Reactions Radiology Nuclear Medicine and imaging Medical diagnosis Physician's Role Lung Neuroradiology AIDS-Related Opportunistic Infections Lung Diseases Fungal medicine.diagnostic_test Receiver operating characteristic business.industry Reproducibility of Results Interventional radiology General Medicine medicine.disease United Kingdom Radiography ROC Curve Radiological weapon Radiology Differential diagnosis business |
| Zdroj: | European Radiology. 14:2030-2037 |
| ISSN: | 1432-1084 0938-7994 |
| DOI: | 10.1007/s00330-004-2447-5 |
| Popis: | The role of clinical information and chest film for the discrimination between invasive pulmonary aspergillosis (IPA) and its differential diagnoses in human immunodeficiency virus (HIV) infection was studied. The diagnostic performance of clinical information and chest film alone and in combination was studied for eight internists and eight radiologists with regular exposure to IPA patients. The multicenter case sample consisted of 25 patients with proven IPA and 25 with other pulmonary diseases typical for HIV. The cases were presented on a CD-ROM. Receiver operating characteristics (ROC) methodology was employed. With clinical information alone, internists achieved the highest diagnostic performance (area under curve/AUC=0.84). Viewing the chest films did not contribute to their performance (AUC=0.80, P=0.26). The radiologist's performance on the basis of viewing the chest film (AUC=0.75) increased significantly ( P=0.012) when clinical information (AUC=0.83) was supplied. IPA cases with characteristic radiological appearance were correctly identified in 90% with chest film. For radiologists with regular exposure to HIV patients, chest films hold relevant information and contribute to the determination in cases with characteristic radiological appearance. Overall and especially in cases with less characteristic radiological appearance, they have significant profit from full access to the clinical data. For internists with regular exposure to HIV patients, chest films do not provide information essential for the verification or differentiation of potential IPA. |
| Databáze: | OpenAIRE |
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