Diagnostic Accuracy of Chest X-Ray for the Diagnosis of Interstitial Lung Disease Keeping High Resolution Computed Tomography (HRCT) as Gold Standard

Article Information

Title: Diagnostic Accuracy of Chest X-Ray for the Diagnosis of Interstitial Lung Disease Keeping High Resolution Computed Tomography (HRCT) as Gold Standard

Authors: Nosheen Sadiq, Ammara Iftikhar, Muhammad Usman Khan, Hussain Rashid Ehsan, Naveed Hussain

Journal: Journal of Bahria University Medical and Dental College (JBUMDC)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2022-07-01	2023-06-30
Y	2021-07-01	2022-06-30

Publisher: Bahria University, Islamabad

Country: Pakistan

Year: 2024

Volume: 14

Issue: 1

Language: English

DOI: 10.51985/JBUMDC202291

Keywords: Chest x-rayinterstitial lung diseasehigh resolution computed tomography

Abstract

Objective: To determine diagnostic accuracy of chest x-ray for the diagnosis of interstitial lung disease keeping high resolution computed tomography as gold standard.
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Study design and setting: Comparative cross sectional study, Department of Radiology PNS Shifa Karachi Methodology: Study done over the period of 1 year and two months. 160 Patients were included by using non-probability consecutive sampling all underwent CXR and HRCT chest. Sample size was calculated using sensitivity and specificity calculator for sample size with expected sensitivity of 80%7, expected specificity of 82.98%7and expected prevalence of 76%7
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Results: In this 160 patients were included by using non probability sampling. Among all 116(72.50%) were males while 44 (27.50%) were females. Sensitivity (SE),specificity, positive predictive value (PPV) negative predictive value(NPV) and diagnostic accuracy of CXR vs HRCT in cases of ILD was 88.89%, 87.50%, 88.89%, 87.50% and 88.24% respectively.
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Conclusion: Chest x-ray has high diagnostic accuracy and simultaneously readily available and cost effective modality, therefore it can be effectively used as alternative to HRCT.

Disclaimer: The following sections are produced through an intensive multi-stage analytical pipeline developed by DefinePK, utilizing advanced natural-language processing, domain-specific knowledge models, and automated cross-referencing systems. Despite the rigor and computational effort involved, the generated summary may still contain inaccuracies or incomplete interpretations. Users are strongly advised to verify all critical information against the original paper and its authoritative sources.

Research Objective

To determine the diagnostic accuracy of chest X-ray for the diagnosis of interstitial lung disease, using high-resolution computed tomography (HRCT) as the gold standard.

Methodology

Comparative cross-sectional study conducted at the Department of Radiology, PNS Shifa Karachi. 160 patients were included using non-probability consecutive sampling. All patients underwent both Chest X-ray (CXR) and HRCT. Sample size was calculated based on expected sensitivity (80%), specificity (82.98%), and prevalence (76%). CXR and HRCT were reported by two different radiologists blinded to each other's findings. Data was analyzed using SPSS-23, calculating sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy.

Methodology Flowchart

                        graph TD;
    A["Patient Recruitment 160 patients"] --> B["Perform CXR and HRCT"];
    B --> C["Radiological Reporting"blinded""];
    C --> D["Data Collection"];
    D --> E["Statistical Analysis - SPSS-23"];
    E --> F["Calculate Diagnostic Accuracy Metrics"];
    F --> G["Formulate Conclusion"];

Discussion

Interstitial lung diseases are complex and present with varied clinical and radiological findings. While HRCT is considered the gold standard for accurate diagnosis and staging, it is expensive and not widely available. Chest X-ray, being cost-effective and readily available, plays a crucial role in initial assessment and can be a useful alternative, especially in resource-limited settings.

Key Findings

The study included 160 patients, with 116 (72.50%) males and 44 (27.50%) females. The diagnostic accuracy of CXR versus HRCT for ILD was: Sensitivity (SE) 88.89%, Specificity 87.50%, Positive Predictive Value (PPV) 88.89%, Negative Predictive Value (NPV) 87.50%, and overall Diagnostic Accuracy 88.24%.

Conclusion

Chest X-ray demonstrates high diagnostic accuracy for interstitial lung disease and, due to its availability and cost-effectiveness, can be effectively used as an alternative to HRCT. Cases with a high index of suspicion may still benefit from HRCT for confirmatory diagnosis.

Fact Check

1. Sample Size: 160 patients were included in the study. (Confirmed in Results section).
2. Gender Distribution: 72.50% of the patients were males. (Confirmed in Results section).
3. Diagnostic Accuracy: The overall diagnostic accuracy of CXR vs HRCT for ILD was reported as 88.24%. (Confirmed in Results section).

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