Fabiola Goda Torlai

Universidade Federal de São Paulo, San Paulo, São Paulo, Brazil

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Publications (4)0 Total impact

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    ABSTRACT: To determine the interobserver and intraobserver agreement in the diagnosis of interstitial lung diseases (ILDs) based on HRCT scans and the impact of observer expertise, clinical data and confidence level on such agreement. Two thoracic radiologists and two general radiologists independently reviewed the HRCT images of 58 patients with ILDs on two distinct occasions: prior to and after the clinical anamnesis. The radiologists selected up to three diagnostic hypotheses for each patient and defined the confidence level for these hypotheses. One of the thoracic and one of the general radiologists re-evaluated the same images up to three months after the first readings. In the coefficient analyses, the kappa statistic was used. The thoracic and general radiologists, respectively, agreed on at least one diagnosis for each patient in 91.4% and 82.8% of the patients. The thoracic radiologists agreed on the most likely diagnosis in 48.3% (kappa = 0.42) and 62.1% (kappa = 0.58) of the cases, respectively, prior to and after the clinical anamnesis; likewise, the general radiologists agreed on the most likely diagnosis in 37.9% (kappa = 0.32) and 36.2% (kappa = 0.30) of the cases. For the thoracic radiologist, the intraobserver agreement on the most likely diagnosis was 0.73 and 0.63 prior to and after the clinical anamnesis, respectively. That for the general radiologist was 0.38 and 0.42.The thoracic radiologists presented almost perfect agreement for the diagnostic hypotheses defined with the high confidence level. Interobserver and intraobserver agreement in the diagnosis of ILDs based on HRCT scans ranged from fair to almost perfect and was influenced by radiologist expertise, clinical history and confidence level.
    Jornal brasileiro de pneumologia: publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia 02/2010; 36(1):29-36.
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    ABSTRACT: PURPOSE To measure inter and intra-observer agreements on the HRCT diagnosis of interstitial lung diseases as well as to evaluate the influence of observer expertise, confidence level and clinical data on observer agreements, comparing two experienced thoracic radiologists with two young general radiologists who received a basic HRCT trainning. METHOD AND MATERIALS HRCT images of 58 patients with ILD were independently reviewed first without and then with clinical information by 2 thoracic and 2 general radiologists. The radiologists listed up to 3 diagnostic hypotheses for each patient and checked the level of confidence for these hypotheses. All the images were reviewed by a thoracic and a general radiologist up to 3 months after the first readings. Statistical analyses were performed using the unadjusted kappa coefficient. RESULTS Thoracic and general radiologists agreed on at least one diagnosis for each patient in 91.4% and 82.8% of patients respectively. Thoracic radiologists agreed on the most likely diagnosis in 48.3% (k= 0,42) and in 62.1% (k= 0,58) of patients before and after the clinical data was provided respectively; general radiologists agreed on the most likely diagnosis in 37.9% (k= 0,32) and 36.2% (k= 0,30) of patients before and after the clinical data provided respectively. Thoracic intra-observer agreement on the most likely diagnosis was present in 74.1% (k= 0,73) and 65.5% (k= 0,63) of patients before and after the clinical data provided respectively. General intra-observer agreement was present in 43.1% (k= 0,38) and 46.6% (k= 0,42) of patients before and after the clinical data provided respectively. Thoracic radiologists presented almost perfect agreements on high confidence level diagnostic hypotheses. CONCLUSION Interobserver and intra-observer agreements on the HRCT diagnosis of ILD ranged from fair to almost perfect and were influenced by the radiologist expertise, clinical information and confidence level for diagnostic hypothesis. In spite of the fact that thoracic and general radiologists showed a high and similar observer agreements, clinical data information had an important contribution just for the former group, who had also a higher level of confidence. CLINICAL RELEVANCE/APPLICATION HRCT has an established role in ILD diagnoses, as the currently accepted gold standard requires a multidisciplinary approach. However observer agreements on its analysis have not been fully evaluated.
    Radiological Society of North America 2009 Scientific Assembly and Annual Meeting; 12/2009
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    ABSTRACT: OBJETIVO: Estabelecer o valor das seqüências ponderadas em T2 para diferenciar cistos simples de hemangiomas hepáticos. MATERIAIS E MÉTODOS: Estudo prospectivo, observacional, transversal e duplo-cego em 52 pacientes com 91 lesões hepáticas (34 cistos simples e 57 hemangiomas) submetidos a ressonância magnética de abdome. A análise conjunta de todas as seqüências realizadas foi considerada o padrão-ouro. Dois observadores independentes avaliaram, subjetivamente, as seqüências TSE com TE longo e B-FFE, procurando diferenciar cistos de hemangiomas. Foram calculadas a eficácia das seqüências e a concordância interobservador e intra-observador por meio do teste kappa (κ) (p < 0,05*). RESULTADOS: As dimensões dos cistos variaram entre 0,5 e 6,5 cm (média de 1,89 cm) e as dos hemangiomas, entre 0,8 e 11 cm (média de 2,62 cm). A concordância entre a avaliação da seqüência com TE longo e o padrão-ouro foi insignificante (κ: 0,00–0,10). A concordância entre a avaliação da seqüência B-FFE e o padrão-ouro variou de substancial (κ: 0,62–0,71) a quase perfeita (κ: 0,86) para ambos os examinadores. A concordância interobservador e intra-observador para a seqüência B-FFE variou entre substancial (κ: 0,62–0,70) e quase perfeita (κ: 0,85–0,91). CONCLUSÃO: A técnica B-FFE apresenta eficácia e reprodutibilidade elevadas na diferenciação de cistos e hemangiomas.
    Radiologia Brasileira 12/2008; 41(6):355-360.
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    ABSTRACT: OBJETIVO: Propor um modelo de padronização de relatório para aneurisma da aorta abdominal na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram realizadas, no período de abril a outubro de 2004, entrevistas com integrantes da Disciplina de Cirurgia Vascular da nossa instituição, para elaboração de um modelo de padronização de relatório de tomografia computadorizada para o estudo do aneurisma da aorta abdominal. A partir deste modelo foi elaborado um questionário, enviado a nove outros cirurgiões, todos com experiência em cirurgia da aorta abdominal. O índice de resposta aos questionários foi de 55,5% (5/9). RESULTADOS: Os parâmetros de interesse citados mais freqüentemente para a avaliação dos aneurismas de aorta abdominal foram: diâmetro máximo do colo proximal, extensão do colo proximal até a artéria renal mais baixa, forma do colo proximal, diâmetro máximo do aneurisma e diâmetro das artérias ilíacas comuns. Estes dados permitiram elaborar uma proposta de modelo para padronização de relatório na tomografia computadorizada. CONCLUSÃO: Um modelo para a análise tomográfica padronizada do aneurisma de aorta abdominal permite atender às necessidades dos cirurgiões vasculares para acompanhar a evolução e planejar o tratamento destes pacientes.
    Radiologia Brasileira 08/2006; 39(4):259-262.