Computed Tomography Observer Agreement in Staging Malignant Lymphoma
Antoinette de Jong1, Thomas C Kwee, Henriëtte M E Quarles van Ufford
1From the *Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht; †Department of Radiology, Medical Center Haaglanden, The Hague; Departments of ‡Radiology and §Nuclear Medicine, Meander Medical Center, Amersfoort; ∥Department of Haematology, VU University Medical Center, Amsterdam; ¶Department of Hematology, Meander Medical Center, Amersfoort; and #Department of Internal Medicine, Bernhove Hospital, Uden; and Departments of **Hematology and ††Radiology, Academic Medical Center, Amsterdam, The Netherlands.
Objective:
To determine pretreatment computed tomography observer agreement in patients with newly diagnosed lymphoma.
Methods:
Forty-nine computed tomography scans were reviewed by 3 experienced radiologists, with each scan assessed twice by 1 observer. Predefined nodal and extranodal regions were assessed, and Ann Arbor stages were assigned. K-statistics were defined as poor (κ < 0.2), fair (κ > 0.2 to κ ≤ 0.4), moderate (κ > 0.4 to κ ≤ 0.6), substantial (κ > 0.6 to κ ≤ 0.8), and almost perfect (κ > 0.8 to κ ≤ 1).
Results:
Nodal interobserver agreement varied from 0.09 for infraclavicular involvement to 0.95 for para-iliac involvement; intraobserver agreement was substantial to almost perfect, except for infraclavicular nodes. Extranodal interobserver agreement varied from 0.56 to 0.88; intraobserver agreement was substantial to almost perfect. Ann Arbor stage interobserver agreement varied from 0.57 to 0.69; intraobserver agreement was substantial.
Conclusion:
Computed tomography observer agreement in staging malignant lymphoma appears to be suboptimal.
