Interobserver variation in the computed tomographic evaluation of mediastinal lymph node size in patients with potentially resectable lung cancer. Canadian Lung Oncology Group.
Interobserver variation in the computed tomographic evaluation of mediastinal lymph node size in patients with potentially resectable lung cancer. Canadian Lung Oncology Group.
复制标题
潜在可切除肺癌患者纵隔淋巴结大小的计算机断层扫描评估的观察者间差异。
作者：
G. Guyatt;M. Lefcoe;S. Walter;D. Cook;S. Troyan;L. Griffith;Derek R. King;C. Zylak;N. Hickey;G. Carrier
目标
旨在衡量胸部计算机断层扫描 (CT) 扫描中纵隔淋巴结大小评估的可靠性。
设计
观察者一致性研究中，放射科医生在不了解彼此解释的情况下，随机读取每人 30 次扫描结果。
人口
负责临床解读的放射科医生（临床放射科医生）和四名对胸部 CT 特别感兴趣的放射科医生（研究放射科医生）对来自明显可手术非小细胞肺癌患者的 60 份扫描进行了读取。
测量值
放射科医生测量了左右上纵隔淋巴结、主动脉淋巴结和隆突下淋巴结的大小，并根据纵隔镜检查可触及的淋巴结是否大于1厘米，建议是否进行纵隔镜检查。一致性使用 kappa 进行量化，kappa 是一种机会校正一致性的度量。
结果
所有放射科医生对于右上纵隔淋巴结是否存在大于1cm的淋巴结的一致性为0.68；左上纵隔淋巴结为 0.28；主动脉肺结节为 0.62；对于隆突下淋巴结，该值为 0.58；对于任何大于 1 厘米且可通过纵隔镜检查的淋巴结，该值为 0.61。当分析仅限于研究放射科医生时，该协议非常相似。
结论
尽管总体一致性良好表明 CT 在评估纵隔淋巴结大小方面提供了有用的信息，但分歧很大，这可能导致 CT 在检测肿瘤扩散方面的敏感性和特异性不理想，这在之前的研究中报告。
OBJECTIVE
To measure the reliability of the assessment of mediastinal lymph node size in computed tomographic (CT) scans of the thorax.
DESIGN
Observer agreement study in which radiologists, blinded to one anothers' interpretation, were randomized to read 30 scans each.
POPULATION
Sixty scans from patients with apparently operable non-small cell carcinoma of the lung were read by radiologists responsible for clinical interpretation (clinical radiologists) and four radiologists with a special interest in thoracic CT (study radiologists).
MEASUREMENTS
Radiologists measured the size of left and right superior mediastinal nodes, aortic nodes, and the subcarinal nodes and, on the basis of whether any nodes accessible to mediastinoscopy were greater than 1 cm, recommended whether mediastinoscopy be undertaken. Agreement was quantified using kappa, a measure of chance-corrected agreement.
RESULTS
Among all radiologists, agreement on whether there were any nodes larger than 1 cm for right superior mediastinal nodes was 0.68; for left superior mediastinal nodes it was 0.28; for aortic pulmonary nodes it was 0.62; for subcarinal nodes it was 0.58; and for any node greater than 1 cm and accessible to mediastinoscopy it was 0.61. The agreement was very similar when the analysis was restricted to the study radiologists.
CONCLUSION
Although the good level of overall agreement suggests that CT provides useful information in the evaluation of mediastinal lymph node size, the disagreement was sufficient that it likely contributes to suboptimal sensitivity and specificity of CT in detecting tumor spread reported in previous studies.
慢性肺部疾病：CT 特异性诊断。
DOI：
10.2214/ajr.152.6.1183
发表时间：
1989
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Bergin,CJ;Coblentz,CL;Chiles,C;Bell,DY;Castellino,RA
通讯作者：
Castellino,RA