Interobserver Variability in the CT Assessment of Honeycombing in the Lungs
Interobserver Variability in the CT Assessment of Honeycombing in the Lungs
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DOI：
10.1148/radiol.12112516
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发表时间：
2013-03-01
期刊：
影响因子：
19.7
通讯作者：
Sugiyama, Yukihiko
中科院分区：
文献类型：
--
作者：
Watadani, Takeyuki;Sakai, Fumikazu;Sugiyama, Yukihiko
目的：量化观察者对胸部计算机断层扫描（CT）识别蜂窝状病变的共识，并分析分歧的原因。材料和方法：机构审查委员会批准了这项符合hipaa的多机构回顾性研究，不需要患者知情同意。5名核心研究成员对80张CT图像进行5分评分（5 =肯定是，1 =肯定不是），建立蜂窝识别的参考标准。来自不同亚专科和地理区域的43名观察员使用相同的评分系统对CT图像进行评分。比较蜂窝化评分与参考标准的加权kappa值，探讨组间差异。将图像分为四组，以便分析存在分歧的病例的成像特征：同意存在蜂窝状，同意不存在蜂窝状，不同意存在蜂窝状和其他（前三组均不适用）。结果：43名观察员的蜂窝状存在得分与参考标准的一致性为中等（Cohen加权kappa值为0.40-0.58）。以亚专科或地理区域定义的组间kappa值无显著差异（Tukey-Kramer检验，P = 0.38 ~ 0.99）。在29%的案例中，对蜂窝的识别存在分歧。这些病例包括蜂窝合并牵引性支气管扩张、大囊肿和合并肺气肿。结论：CT对蜂窝状的识别是主观的，而不同的意见在很大程度上是由模拟蜂窝状的条件引起的。(c) rsna, 2012
Purpose: To quantify observer agreement and analyze causes of disagreement in identifying honeycombing at chest computed tomography (CT).Materials and Methods: The institutional review board approved this multi-institutional HIPAA-compliant retrospective study, and informed patient consent was not required. Five core study members scored 80 CT images with a five-point scale (5 = definitely yes to 1 = definitely no) to establish a reference standard for the identification of honeycombing. Forty-three observers from various subspecialties and geographic regions scored the CT images by using the same scoring system. Weighted kappa values of honeycombing scores compared with the reference standard were analyzed to investigate intergroup differences. Images were divided into four groups to allow analysis of imaging features of cases in which there was disagreement: agreement on the presence of honeycombing, agreement on the absence of honeycombing, disagreement on the presence of honeycombing, and other (none of the preceding three groups applied).Results: Agreement of scores of honeycombing presence by 43 observers with the reference standard was moderate (Cohen weighted kappa values: 0.40-0.58). There were no significant differences in kappa values among groups defined by either subspecialty or geographic region (Tukey-Kramer test, P = .38 to >.99). In 29% of cases, there was disagreement on identification of honeycombing. These cases included honeycombing mixed with traction bronchiectasis, large cysts, and superimposed pulmonary emphysema.Conclusion: Identification of honeycombing at CT is subjective, and disagreement is largely caused by conditions that mimic honeycombing. (C) RSNA, 2012