Fatania, K, Brown, PJ, Xie, C et al. (6 more authors) (2020) Multi-observer concordance and accuracy of the British Thoracic Society scale and other visual assessment qualitative criteria for solid pulmonary nodule assessment using FDG PET-CT. Clinical Radiology, 75 (11). 878.E21-878.E28. ISSN 0009-9260
Abstract
AIM:
To compare the interobserver reliability and diagnostic accuracy of the British Thoracic Society (BTS) scale and other visual assessment criteria in the context of 2-[ 18F]-fluoro-2-deoxy- d-glucose (FDG) positron-emission tomography (PET)-computed tomography (CT) evaluation of solid pulmonary nodules (SPNs).
MATERIALS AND METHODS:
Fifty patients who underwent FDG PET-CT for assessment of a SPN were identified. Seven reporters with varied experience at four centres graded FDG uptake visually using the British Thoracic Society (BTS) four-point scale. Five reporters also scored SPNs according to three- and five-point visual assessment scales and using semi-quantitative assessment (maximum standardised uptake value [SUV max]). Interobserver reliability was assessed with the intra-class correlation coefficient (ICC) and weighted Cohen's kappa (κ). Diagnostic performance was evaluated by receiver operator characteristic (ROC) analysis.
RESULTS:
Good interobserver reliability was demonstrated with the BTS scale (ICC=0.78, 95% confidence interval [CI]: 0.69–0.85) and five-point scale (ICC=0.78, 95 CI 0.68–0.86), whilst the three-point scale demonstrated moderate reliability (ICC=0.70, 95% CI: 0.59–0.80). Almost perfect agreement was achieved between two consultants (κ=0.85), and substantial agreement between two other consultants (κ=0.78) using the BTS scale. ROC curves for the BTS and five-point scales demonstrated equivalent accuracy (BTS area under the ROC curve [AUC]=0.768; five-point AUC=0.768). SUV max was no more accurate compared to the BTS scale (SUV max AUC=0.794; BTS AUC=0.768, p=0.43).
CONCLUSIONS:
The BTS scale can be applied reliably by reporters with varied levels of PET-CT reporting experience, across different centres and has a diagnostic performance that is not surpassed by alternative scales.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved. This is an author produced version of an article published in Clinical Radiology. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Aug 2020 11:31 |
Last Modified: | 19 Jan 2023 12:53 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.crad.2020.06.028 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:164102 |