Inter-observer agreement of paranasal sinus computed tomography scans

Area of Science:

• Otolaryngology
• Radiology
• Surgical Anatomy

Background:

• Chronic rhinosinusitis (CRS) often requires surgical intervention after medical treatment failure.
• Pre-operative computed tomography (CT) scans are crucial for planning safe and effective sinus surgery.
• Evaluating inter-observer agreement in interpreting these CT scans is essential for surgical planning.

Purpose of the Study:

• To prospectively assess the inter-observer agreement of anatomical and surgical structures on sinus CT scans in CRS patients.
• To test the hypothesis that observer agreement is good for these evaluations.

Main Methods:

• 57 CRS patients' sinus CT scans were analyzed by three observers: a radiologist, an ENT surgeon, and an ENT resident.
• Lund-Mackay (LM) scores and 43 other structural parameters were assessed in a blinded manner.
• Reproducibility was quantified using Cohen's kappa coefficient.

Main Results:

• Overall, moderate inter-observer agreement was observed for most structures.
• Poor reproducibility was specifically noted for the optic nerve, uncinated process insertion, anterior ethmoidal artery, and Keros class.
• These findings indicate variability in the interpretation of key surgical landmarks.

Conclusions:

• Considerable inter-observer variation exists for surgically important structures on sinus CT scans in CRS patients.
• This variability underscores the importance of thorough consultation and consensus when interpreting scans for advanced sinus surgery planning.
• Standardized interpretation protocols may be beneficial to improve agreement.