Lung cancer: Interobserver agreement on interpretation of pulmonary findings at low-dose CT screening
Lung cancer: Interobserver agreement on interpretation of pulmonary findings at low-dose CT screening
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DOI：
10.1148/radiol.2461062097
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发表时间：
2008-01-01
期刊：
影响因子：
19.7
通讯作者：
Strollo, Diane C.
中科院分区：
文献类型：
--
作者：
Gierada, David S.;Pilgram, Thomas K.;Strollo, Diane C.
目的：评价放射科医师对肺癌低剂量CT筛查中肺部表现解释的一致性。材料和方法：获得机构评审委员会的批准和知情同意。遵循HIPAA指南。来自国家癌症研究所肺筛查研究网络的10个国家肺部筛查试验筛查中心的16名放射科医生回顾了135名试验参与者(89名男性，46名女性；平均年龄62.7岁+/-5.4[标准差])的135次基线低剂量筛查CT检查的图像亚组。解释分为以下四种类型之一：未分类结节，最大横径大于或等于4 mm(筛查阳性)；未钙化结节，最大横径小于4 mm(筛查阴性)；钙化，良性结节(筛查结果阴性)；或无结节(筛查结果阴性)。对每个案例都提出了后续评价的建议。结果：多评定者kappa值从0.58(所有四个分类的一致性，95%可信区间：0.55，0.61)到0.64(对阳性或阴性筛查结果的分类一致，95%可信区间：0.62，0.65)。每个病例中与筛查结果一致的读者对的平均百分比(符合百分比)为82%。发现的异常和归类为肺结节的总数量差异很大，放射科医生之间的差异高达两倍以上。对于阳性病例，随访建议的多重评价者kappa值为0.35。结论：观察者间的一致性为中度到实质性；仍有相当大的改善潜力。(C)RSNA，2007年。
Purpose: To evaluate agreement among radiologists on the interpretation of pulmonary findings at low-dose computed tomographic (CT) screening examinations for lung cancer.Materials and Methods: Institutional review board approval and informed consent were obtained. HIPAA guidelines were followed. Sixteen radiologists from the 10 National Lung Screening Trial screening centers of the National Cancer Institute's Lung Screening Study network reviewed image subsets from 135 baseline low-dose screening CT examinations in 135 trial participants (89 men, 46 women; mean age, 62.7 years +/- 5.4 [standard deviation]). Interpretations were classified into one of four of the following categories: non-classified nodule 4 mm or larger in greatest transverse dimension (positive screening result); noncalcified nodule smaller than 4 mm in greatest transverse dimension (negative screening result); calcified, benign nodule (negative screening result); or no nodule (negative screening result). A recommendation for follow-up evaluation was obtained for each case. Interobserver agreement was evaluated by using the multirater kappa statistic and by using response frequencies and descriptive statistics.Results: Multirater kappa values ranged from 0.58 (for agreement among all four classifications; 95% confidence interval: 0.55, 0.61) to 0.64 (for agreement on classification as a positive or negative screening result; 95% confidence interval: 0.62, 0.65). The average percentage of reader pairs in agreement on the screening result per case (percentage agreement) was 82%. There was wide variation in the total number of abnormalities detected and classified as pulmonary nodules, with differences of up to more than twofold among radiologists. For cases classified as positive, multirater kappa for follow-up recommendations was 0.35.Conclusion: Interobserver agreement was moderate to substantial; potential for considerable improvement exists. (c) RSNA, 2007.