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  4. Assisted versus Manual Interpretation of Low-Dose CT Scans for Lung Cancer Screening: Impact on Lung-RADS Agreement
 
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2021
Journal Article
Title

Assisted versus Manual Interpretation of Low-Dose CT Scans for Lung Cancer Screening: Impact on Lung-RADS Agreement

Abstract
An observer study with seven radiologists showed that using a dedicated CT lung screening viewer (with computer-aided detection, a segmentation algorithm, and automatic Lung Imaging Reporting and Data System [Lung-RADS] categorization) improved interobserver agreement for Lung-RADS categorization while substantially reducing the reading time. Purpose. To compare the inter- and intraobserver agreement and reading times achieved when assigning Lung Imaging Reporting and Data System (Lung-RADS) categories to baseline and follow-up lung cancer screening studies by using a dedicated CT lung screening viewer with integrated nodule detection and volumetric support with those achieved by using a standard picture archiving and communication system (PACS)-like viewer. Materials and Methods. Data were obtained from the National Lung Screening Trial (NLST). By using data recorded by NLST radiologists, scans were assigned to Lung-RADS categories. For each Lung-RADS category (1 or 2, 3, 4A, and 4B), 40 CT scans (20 baseline scans and 20 follow-up scans) were randomly selected for 160 participants (median age, 61 years; interquartile range, 58-66 years; 61 women) in total. Seven blinded observers independently read all CT scans twice in a randomized order with a 2-week washout period: once by using the standard PACS-like viewer and once by using the dedicated viewer. Observers were asked to assign a Lung-RADS category to each scan and indicate the risk-dominant nodule. Inter- and intraobserver agreement was analyzed by using Fleiss k values and Cohen weighted k values, respectively. Reading times were compared by using a Wilcoxon signed rank test. Results. The interobserver agreement was moderate for the standard viewer and substantial for the dedicated viewer, with Fleiss k values of 0.58 (95% CI: 0.55, 0.60) and 0.66 (95% CI: 0.64, 0.68), respectively. The intraobserver agreement was substantial, with a mean Cohen weighted k value of 0.67. The median reading time was significantly reduced from 160 seconds with the standard viewer to 86 seconds with the dedicated viewer (P < .001). Conclusion. Lung-RADS interobserver agreement increased from moderate to substantial when using the dedicated CT lung screening viewer. The median reading time was substantially reduced when scans were read by using the dedicated CT lung screening viewer.
Author(s)
Jacobs, C.
Schreuder, A.
Riel, S.J. van
Scholten, E.Th.
Wittenberg, R.
Wille, M.M.W.
Hoop, B. de
Sprengers, R.
Mets, O.M.
Geurts, B.
Prokop, M.
Schaefer-Prokop, C.
Ginneken, B. van
Journal
Radiology. Imaging cancer  
Open Access
DOI
10.1148/rycan.2021200160
Language
English
Fraunhofer-Institut für Digitale Medizin MEVIS  
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