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J Nucl Med. 2008; 49 (Supplement 1):274P
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General Clinical Specialties: Operations/Practice Based/Outcomes Research

Operations/Practice Based/Outcomes Research Posters

Observer variation in FDG PET-CT for staging of non small cell lung carcinoma

Michael Hofman1, Nigel Smeeton2, Tom Nunan3, Sheila Rankin3 and Michael O'Doherty3

1 Department of Nuclear Medicine, Monash Medical Centre, Melbourne, Victoria, Australia; 2 Medical Statistics, Kings College London, London, United Kingdom; 3 Clinical PET Centre at St Thomas', Kings College London / Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom

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Objectives: Error and variation in reporting remains one of the weakest features of clinical imaging despite enormous technological advances in nuclear medicine and radiology. This study aims to evaluate agreement amongst experienced readers in staging non-small cell lung cancer with PET/CT.

Methods: 100 consecutive 18F-FDG PET/CT studies were reviewed in a blinded fashion by three experienced reporters. Two readers reviewed each series a second time. Each rated individual mediastinal lymph stations as benign, inflammatory, equivocal or malignant, and presence of metastatic disease. Each also assigned overall AJCC N and M stage. Kappa ({kappa}) and weighted kappa ({kappa}w) statistics were used to compare groups.

Results: Both intra- and inter-observer assessment of N and M staging were highly reproducible. For M staging there was near complete agreement, with intra- and inter-observer kappa values between 0.90 and 0.93. For N staging, there was excellent agreement with weighted kappa of 0.91 and 0.79 for intra-observer and 0.75 - 0.81 for inter-observer agreement. There was high agreement for inferior and superior mediastinal nodes (stations 1, 2, 3, 7, 8 9) ({kappa}w=0.71-0.88) and moderate agreement for hilar (10) ({kappa}w=0.56-0.71) and aortopulmonary nodes (5, 6) ({kappa}w=0.48-0.53).

Conclusions: Amongst experienced reporters in a single centre, there was a very high level of agreement for both overall mediastinal nodal stage and detection of distant metastases with PET-CT.





This Article
Services
Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Hofman, M.
Right arrow Articles by O'Doherty, M.
PubMed
Right arrow Articles by Hofman, M.
Right arrow Articles by O'Doherty, M.