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Differentiating between Subsolid and Solid Pulmonary Nodules at CT: Inter- and Intraobserver Agreement between

Carole A Ridge1, Afra Yildirim1, Phillip M Boiselle1

  • 1From the Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland (C.A.R.); Department of Radiology, Gevher Nesibe Hospital, University of Erciyes, Kayseri, Turkey (A.Y.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (P.M.B., A.A.B.); Department of Radiology, Hospital de Sant Pau, Barcelona, Spain (T.F.); Department of Radiology, Meander Medical Centre, Amersfoort, the Netherlands (C.M.S.P.); Department of Radiology, Universitair Medisch Centrum St. Radboud, Nijmegen, the Netherlands (C.M.S.P.); Department of Radiology, Epicura Hospital, Clinique Louis Caty, Baudour, Belgium (D.T.); and Department of Radiology, Erasmus Hospital, University of Brussels, Brussels, Belgium (P.A.G.).

Radiology
|October 13, 2015
PubMed
Summary

Experienced thoracic radiologists showed varied accuracy and reproducibility in classifying subsolid versus solid pulmonary nodules on CT scans. This inconsistency may impact patient management and prognosis.

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Area of Science:

  • Radiology
  • Pulmonary Medicine
  • Medical Imaging

Background:

  • Accurate differentiation between subsolid and solid pulmonary nodules on CT is crucial for patient management.
  • Variability in radiologist interpretation can affect surveillance and prognostic decisions.

Purpose of the Study:

  • To quantify the reproducibility and accuracy of experienced thoracic radiologists in differentiating between subsolid and solid pulmonary nodules using CT.
  • Assess inter- and intraobserver agreement among thoracic radiologists.

Main Methods:

  • A multicenter study involving six experienced thoracic radiologists.
  • A database of 120 pulmonary nodules (10 solid, 10 subsolid) was created as the reference standard.
  • Each radiologist interpreted nodules in two separate sessions, with agreement assessed using kappa statistics and correlation with nodule size.

Main Results:

  • Interobserver agreement kappa values ranged from 0.469 to 0.839 across sessions.
  • Intraobserver agreement kappa was 0.792.
  • Correct classification of nodules averaged 58% across all radiologists and sessions.
  • Nodule size showed a weak correlation with correct classification.

Conclusions:

  • The reproducibility and accuracy of thoracic radiologists in classifying subsolid versus solid pulmonary nodules varied.
  • Inconsistent classification may impact surveillance recommendations and prognostic determinations for patients with pulmonary nodules.