BACKGROUND: In the current lung cancer tumor-node-metastasis classification, solid tumor size is used for tumor diameter measurement as the dense component. However, measuring solid tumor size is sometimes difficult and inter-observer variability may increase, particularly in part-solid nodules with ground-glass opacity (GGO). This study aimed to investigate inter-observer size measurement variability in lung adenocarcinoma. METHODS: Of 47 patients with part-solid lung adenocarcinoma who had undergone surgery at our department from January to December 2016, five surgeons and one radiologist undertook unidimensional solid and total size tumor measurements using pre-operative axial computed tomography images, and we assessed inter-observer size measurement variability. Variability was then subclassified into five groups, according to computer tomography-identified tumor morphological characteristics, namely: (I) minimally invasive; (II) peribronchovascular; (III) spiculation/atelectasis; (IV) adjacent to cystic lesion, and; (V) diffuse consolidation and GGO. RESULTS: The mean inter-observer variability was 9.7 mm (solid size) and 7.7 mm (total size). Analysis of the maximum and minimum measurement size values for each patient undertaken showed that the most experienced surgeon and the radiologist measured the minimum size more frequently. To correct for differences in mean tumor diameter in each group, a comparison was made using a coefficient of variation (CV) calculated as the ratio of the standard deviation to the mean. Group I characteristics showed the largest coefficient value for variation in solid size measurement. CONCLUSIONS: Inter-observer measurement variability for solid size was larger than for total size in lung adenocarcinoma. Large variability in group I indicated the difficulty of size measurement for low-grade malignant potential nodules such as adenocarcinoma in situ, minimally invasive adenocarcinoma, and early-stage invasive adenocarcinoma. The possibility of unavoidable size measurement variability should be recognized when deciding on surgical procedures for these diseases.
BACKGROUND: In the current lung cancer tumor-node-metastasis classification, solid tumor size is used for tumor diameter measurement as the dense component. However, measuring solid tumor size is sometimes difficult and inter-observer variability may increase, particularly in part-solid nodules with ground-glass opacity (GGO). This study aimed to investigate inter-observer size measurement variability in lung adenocarcinoma. METHODS: Of 47 patients with part-solid lung adenocarcinoma who had undergone surgery at our department from January to December 2016, five surgeons and one radiologist undertook unidimensional solid and total size tumor measurements using pre-operative axial computed tomography images, and we assessed inter-observer size measurement variability. Variability was then subclassified into five groups, according to computer tomography-identified tumor morphological characteristics, namely: (I) minimally invasive; (II) peribronchovascular; (III) spiculation/atelectasis; (IV) adjacent to cystic lesion, and; (V) diffuse consolidation and GGO. RESULTS: The mean inter-observer variability was 9.7 mm (solid size) and 7.7 mm (total size). Analysis of the maximum and minimum measurement size values for each patient undertaken showed that the most experienced surgeon and the radiologist measured the minimum size more frequently. To correct for differences in mean tumor diameter in each group, a comparison was made using a coefficient of variation (CV) calculated as the ratio of the standard deviation to the mean. Group I characteristics showed the largest coefficient value for variation in solid size measurement. CONCLUSIONS: Inter-observer measurement variability for solid size was larger than for total size in lung adenocarcinoma. Large variability in group I indicated the difficulty of size measurement for low-grade malignant potential nodules such as adenocarcinoma in situ, minimally invasive adenocarcinoma, and early-stage invasive adenocarcinoma. The possibility of unavoidable size measurement variability should be recognized when deciding on surgical procedures for these diseases.
Authors: Geoffrey R Oxnard; Binsheng Zhao; Camelia S Sima; Michelle S Ginsberg; Leonard P James; Robert A Lefkowitz; Pingzhen Guo; Mark G Kris; Lawrence H Schwartz; Gregory J Riely Journal: J Clin Oncol Date: 2011-07-05 Impact factor: 44.544
Authors: William D Travis; Kavita Garg; Wilbur A Franklin; Ignacio I Wistuba; Bradley Sabloff; Masayuki Noguchi; Ryutaro Kakinuma; Maureen Zakowski; Michelle Ginsberg; Robert Padera; Francine Jacobson; Bruce E Johnson; Fred Hirsch; Elizabeth Brambilla; Douglas B Flieder; Kim R Geisinger; Frederik Thunnisen; Keith Kerr; David Yankelevitz; Teri J Franks; Jeffrey R Galvin; Douglas W Henderson; Andrew G Nicholson; Philip S Hasleton; Victor Roggli; Ming-Sound Tsao; Federico Cappuzzo; Madeline Vazquez Journal: J Clin Oncol Date: 2005-05-10 Impact factor: 44.544
Authors: William D Travis; Kavita Garg; Wilbur A Franklin; Ignacio I Wistuba; Bradley Sabloff; Masayuki Noguchi; Ryutaro Kakinuma; Maureen Zakowski; Michelle Ginsberg; Robert Padera; Francine Jacobson; Bruce E Johnson; Fred Hirsch; Elizabeth Brambilla; Douglas B Flieder; Kim R Geisinger; Frederik Thunnissen; Keith Kerr; David Yankelevitz; Teri J Franks; Jeffrey R Galvin; Douglas W Henderson; Andrew G Nicholson; Philip S Hasleton; Victor Roggli; Ming-Sound Tsao; Federico Cappuzzo; Madeline Vazquez Journal: J Thorac Oncol Date: 2006-11 Impact factor: 15.609
Authors: William D Travis; Elisabeth Brambilla; Masayuki Noguchi; Andrew G Nicholson; Kim R Geisinger; Yasushi Yatabe; David G Beer; Charles A Powell; Gregory J Riely; Paul E Van Schil; Kavita Garg; John H M Austin; Hisao Asamura; Valerie W Rusch; Fred R Hirsch; Giorgio Scagliotti; Tetsuya Mitsudomi; Rudolf M Huber; Yuichi Ishikawa; James Jett; Montserrat Sanchez-Cespedes; Jean-Paul Sculier; Takashi Takahashi; Masahiro Tsuboi; Johan Vansteenkiste; Ignacio Wistuba; Pan-Chyr Yang; Denise Aberle; Christian Brambilla; Douglas Flieder; Wilbur Franklin; Adi Gazdar; Michael Gould; Philip Hasleton; Douglas Henderson; Bruce Johnson; David Johnson; Keith Kerr; Keiko Kuriyama; Jin Soo Lee; Vincent A Miller; Iver Petersen; Victor Roggli; Rafael Rosell; Nagahiro Saijo; Erik Thunnissen; Ming Tsao; David Yankelewitz Journal: J Thorac Oncol Date: 2011-02 Impact factor: 15.609
Authors: C B Caldwell; K Mah; Y C Ung; C E Danjoux; J M Balogh; S N Ganguli; L E Ehrlich Journal: Int J Radiat Oncol Biol Phys Date: 2001-11-15 Impact factor: 7.038
Authors: David P Naidich; Alexander A Bankier; Heber MacMahon; Cornelia M Schaefer-Prokop; Massimo Pistolesi; Jin Mo Goo; Paolo Macchiarini; James D Crapo; Christian J Herold; John H Austin; William D Travis Journal: Radiology Date: 2012-10-15 Impact factor: 11.105
Authors: Hyungjin Kim; Chang Min Park; Sungmin Woo; Sang Min Lee; Hyun-Ju Lee; Chul-Gyu Yoo; Jin Mo Goo Journal: Radiology Date: 2013-07-17 Impact factor: 11.105