Katharina Martini1, Thorsten Ottilinger2, Bettina Serrallach2, Stefan Markart2, Nicola Glaser-Gallion2, Christian Blüthgen1, Sebastian Leschka3, Ralf W Bauer4, Simon Wildermuth2, Michael Messerli5. 1. Department of Nuclear Medicine, University Hospital Zurich, University Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Switzerland. 2. Division of Radiology and Nuclear Medicine, Cantonal Hospital, St. Gallen, Switzerland. 3. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Switzerland; Division of Radiology and Nuclear Medicine, Cantonal Hospital, St. Gallen, Switzerland. 4. Division of Radiology and Nuclear Medicine, Cantonal Hospital, St. Gallen, Switzerland; RNS Gemeinschaftspraxis GbR, Wiesbaden, Germany. 5. Department of Nuclear Medicine, University Hospital Zurich, University Zurich, Switzerland. Electronic address: michael.messerli@usz.ch.
Abstract
PURPOSE: To assess the interreader variability of submillisievert CT for lung cancer screening in radiologists with various experience levels. METHOD: Six radiologists with different degrees of clinical experience in radiology (range, 1-15 years), rated 100 submillisievert CT chest studies as either negative screening finding (no nodules, benign nodules, nodules <5 mm), indeterminate finding (nodules 5-10 mm), positive finding (nodules >10 mm). Each radiologist interpreted scans randomly ordered and reading time was recorded. Interobserver agreement was assessed with ak statistic. Reasons for differences in nodule classification were analysed on a case-by-case basis. Reading time was correlated with reader experience using Pearson correlation (r). RESULTS: The overall interobserver agreement between all readers was moderate (k = 0.454; p < 0.001). In 57 patients, all radiologists agreed on the differentiation of negative and indeterminate/positive finding. In 64 cases disagreement between readers led to different nodule classification. In 8 cases some readers rated the nodule as benign, whereas others scored the case as positive. Overall, disagreement in nodule classification was mostly due to failure in identification of target lesion (n = 40), different lesion measurement (n = 44) or different classification (n = 26). Mean overall reading time per scan was of 2 min 2 s (range: 7s-7 min 45 s) and correlated with reader-experience (r = -0.824). CONCLUSIONS: Our study showed substantial interobserver variability for the detection and classification of pulmonary nodules in submillisievert CT. This highlights the importance for careful standardisation of screening programs with the objective of harmonizing efforts of involved radiologists across different institutions by defining and assuring quality standards.
PURPOSE: To assess the interreader variability of submillisievert CT for lung cancer screening in radiologists with various experience levels. METHOD: Six radiologists with different degrees of clinical experience in radiology (range, 1-15 years), rated 100 submillisievert CT chest studies as either negative screening finding (no nodules, benign nodules, nodules <5 mm), indeterminate finding (nodules 5-10 mm), positive finding (nodules >10 mm). Each radiologist interpreted scans randomly ordered and reading time was recorded. Interobserver agreement was assessed with ak statistic. Reasons for differences in nodule classification were analysed on a case-by-case basis. Reading time was correlated with reader experience using Pearson correlation (r). RESULTS: The overall interobserver agreement between all readers was moderate (k = 0.454; p < 0.001). In 57 patients, all radiologists agreed on the differentiation of negative and indeterminate/positive finding. In 64 cases disagreement between readers led to different nodule classification. In 8 cases some readers rated the nodule as benign, whereas others scored the case as positive. Overall, disagreement in nodule classification was mostly due to failure in identification of target lesion (n = 40), different lesion measurement (n = 44) or different classification (n = 26). Mean overall reading time per scan was of 2 min 2 s (range: 7s-7 min 45 s) and correlated with reader-experience (r = -0.824). CONCLUSIONS: Our study showed substantial interobserver variability for the detection and classification of pulmonary nodules in submillisievert CT. This highlights the importance for careful standardisation of screening programs with the objective of harmonizing efforts of involved radiologists across different institutions by defining and assuring quality standards.
Authors: Andrea N Burnett-Hartman; Nikki M Carroll; Stacey A Honda; Caroline Joyce; Nandita Mitra; Christine Neslund-Dudas; Oluwatosin Olaiya; Katharine A Rendle; Mitchell D Schnall; Anil Vachani; Debra P Ritzwoller Journal: Ann Am Thorac Soc Date: 2022-03
Authors: Joel G Fletcher; David L Levin; Anne-Marie G Sykes; Rebecca M Lindell; Darin B White; Ronald S Kuzo; Vighnesh Suresh; Lifeng Yu; Shuai Leng; David R Holmes; Akitoshi Inoue; Matthew P Johnson; Rickey E Carter; Cynthia H McCollough Journal: Radiology Date: 2020-09-29 Impact factor: 11.105
Authors: Matthias May; Rafael Heiss; Julia Koehnen; Matthias Wetzl; Marco Wiesmueller; Christoph Treutlein; Lars Braeuer; Michael Uder; Markus Kopp Journal: Invest Radiol Date: 2022-03-01 Impact factor: 6.016