Tetsuro Araki1, Lynette M Sholl2, Victor H Gerbaudo1, Hiroto Hatabu1, Mizuki Nishino3. 1. Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, 02215 MA. 2. Department of Pathology, Brigham and Women's Hospital, Boston, MA. 3. Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, 02215 MA; Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, 02215 MA. Electronic address: Mizuki_Nishino@DFCI.HARVARD.EDU.
Abstract
RATIONALE AND OBJECTIVES: To determine the intraobserver and interobserver variabilities of thymic measurements on computed tomography (CT) in patients with pathologic diagnosis of thymic hyperplasia or normal thymus. MATERIALS AND METHODS: Thirty-three patients with pathologic diagnosis of thymic hyperplasia (n = 25) or normal thymus (n = 8) who had identifiable thymus gland on CT were retrospectively studied. Two radiologists independently measured thymic size and CT attenuation. Concordance correlation coefficients (CCCs) and Bland-Altman plots were used to assess intraobserver and interobserver agreements. RESULTS: The intraobserver and interobserver agreements of thymic diameters and the lobe length were moderate, with CCCs ranging from 0.73 to 0.89 and from 0.72 to 0.81, respectively. Higher agreement was noted among patients whose measurements were performed on the same CT image in two independent measurements, with intraobserver CCC ≥ 0.95 for diameters and length. After providing readers with an instruction for consistent selection of CT image for measurements, the intraobserver and interobserver agreements improved, resulting in CCCs ranging from 0.81 to 0.92 and from 0.77 to 0.85 for diameters and length, respectively. Thymic lobe thickness had the least agreement. CT attenuation measurements were highly reproducible, with CCCs ranging from 0.88 to 0.97. In patients with thymic CT attenuation >30 HU (Hounsfield unit), the attenuation measurements were more reproducible with narrower 95% limits of agreement. CONCLUSIONS: Thymic size measurements had moderate-to-high intraobserver and interobserver agreements, when the instruction for consistent selection of images was provided to the readers. CT attenuation was highly reproducible, with higher reproducibility for thymic glands with >30 HU. Awareness of thymic measurement variability is necessary when interpreting measured values of normal thymus and thymic pathology on CT.
RATIONALE AND OBJECTIVES: To determine the intraobserver and interobserver variabilities of thymic measurements on computed tomography (CT) in patients with pathologic diagnosis of thymic hyperplasia or normal thymus. MATERIALS AND METHODS: Thirty-three patients with pathologic diagnosis of thymic hyperplasia (n = 25) or normal thymus (n = 8) who had identifiable thymus gland on CT were retrospectively studied. Two radiologists independently measured thymic size and CT attenuation. Concordance correlation coefficients (CCCs) and Bland-Altman plots were used to assess intraobserver and interobserver agreements. RESULTS: The intraobserver and interobserver agreements of thymic diameters and the lobe length were moderate, with CCCs ranging from 0.73 to 0.89 and from 0.72 to 0.81, respectively. Higher agreement was noted among patients whose measurements were performed on the same CT image in two independent measurements, with intraobserver CCC ≥ 0.95 for diameters and length. After providing readers with an instruction for consistent selection of CT image for measurements, the intraobserver and interobserver agreements improved, resulting in CCCs ranging from 0.81 to 0.92 and from 0.77 to 0.85 for diameters and length, respectively. Thymic lobe thickness had the least agreement. CT attenuation measurements were highly reproducible, with CCCs ranging from 0.88 to 0.97. In patients with thymic CT attenuation >30 HU (Hounsfield unit), the attenuation measurements were more reproducible with narrower 95% limits of agreement. CONCLUSIONS: Thymic size measurements had moderate-to-high intraobserver and interobserver agreements, when the instruction for consistent selection of images was provided to the readers. CT attenuation was highly reproducible, with higher reproducibility for thymic glands with >30 HU. Awareness of thymic measurement variability is necessary when interpreting measured values of normal thymus and thymic pathology on CT.
Authors: Mizuki Nishino; Mengye Guo; David M Jackman; Pamela J DiPiro; Jeffrey T Yap; Tak K Ho; Hiroto Hatabu; Pasi A Jänne; Annick D Van den Abbeele; Bruce E Johnson Journal: Acad Radiol Date: 2010-10-30 Impact factor: 3.173
Authors: Mizuki Nishino; Simon K Ashiku; Olivier N Kocher; Robert L Thurer; Phillip M Boiselle; Hiroto Hatabu Journal: Radiographics Date: 2006 Mar-Apr Impact factor: 5.333
Authors: Binsheng Zhao; Leonard P James; Chaya S Moskowitz; Pingzhen Guo; Michelle S Ginsberg; Robert A Lefkowitz; Yilin Qin; Gregory J Riely; Mark G Kris; Lawrence H Schwartz Journal: Radiology Date: 2009-07 Impact factor: 11.105
Authors: A V Moore; M Korobkin; W Olanow; D K Heaston; P C Ram; N R Dunnick; P M Silverman Journal: AJR Am J Roentgenol Date: 1983-08 Impact factor: 3.959
Authors: Tetsuro Araki; Mizuki Nishino; Wei Gao; Josée Dupuis; Rachel K Putman; George R Washko; Gary M Hunninghake; George T O'Connor; Hiroto Hatabu Journal: Thorax Date: 2015-10-29 Impact factor: 9.139
Authors: Tetsuro Araki; Mizuki Nishino; Wei Gao; Josée Dupuis; Gary M Hunninghake; Takamichi Murakami; George R Washko; George T O'Connor; Hiroto Hatabu Journal: Eur Radiol Date: 2015-04-30 Impact factor: 5.315
Authors: Tetsuro Araki; Mizuki Nishino; Wei Gao; Josée Dupuis; George R Washko; Gary M Hunninghake; Takamichi Murakami; George T O'Connor; Hiroto Hatabu Journal: Eur J Radiol Open Date: 2015