Interobserver size measurement variability in part-solid lung adenocarcinoma using pre-operative computed tomography.

Area of Science:

• Pulmonology
• Oncology
• Radiology

Background:

• Current lung cancer staging relies on solid tumor size, but measurement is difficult for part-solid nodules with ground-glass opacity (GGO).
• This difficulty can increase inter-observer variability in tumor diameter measurements.
• Investigating this variability is crucial for accurate lung cancer classification.

Purpose of the Study:

• To assess inter-observer size measurement variability in lung adenocarcinoma.
• To analyze variability based on specific tumor morphological characteristics.

Main Methods:

• Five surgeons and one radiologist measured solid and total tumor sizes on pre-operative CT images of 47 patients.
• Measurements were categorized into five groups based on tumor morphology (minimally invasive, peribronchovascular, etc.).
• Inter-observer variability was quantified using the coefficient of variation (CV).

Main Results:

• Mean inter-observer variability was 9.7 mm for solid size and 7.7 mm for total size.
• The most experienced surgeon and radiologist tended to measure smaller sizes.
• Group I (minimally invasive) showed the highest CV for solid size measurement variability.

Conclusions:

• Solid tumor size measurement in lung adenocarcinoma exhibits greater inter-observer variability than total size.
• High variability in minimally invasive types (Group I) highlights measurement challenges for early-stage cancers.
• This inherent variability necessitates careful consideration during surgical planning for these nodules.