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Related Concept Videos

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Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Related Experiment Video

Updated: Nov 12, 2025

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Interobserver variability in Lung CT Screening Reporting and Data System categorisation in subsolid nodule-enriched

Sung Hyun Yoon1, Yong Ju Kim1, Kibbeum Doh2

  • 1Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeongi-do, 13620, Korea.

European Radiology
|March 18, 2021
PubMed
Summary

Radiologist agreement in Lung CT Screening Reporting and Data System (Lung-RADS) categorization for subsolid nodules is moderate. Experienced radiologists showed better accuracy, but inconsistencies may impact lung cancer screening management.

Keywords:
Cancer screeningLung neoplasmsObserver variationSolitary pulmonary noduleX-ray computed tomography

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Area of Science:

  • Radiology
  • Medical Imaging
  • Thoracic Imaging

Background:

  • Low-dose computed tomography (LDCT) screening is crucial for lung cancer detection.
  • Subsolid nodules on LDCT require careful categorization using systems like Lung Imaging Reporting and Data System (Lung-RADS).
  • Interobserver agreement in categorizing these nodules is essential for consistent patient management.

Purpose of the Study:

  • To evaluate the interobserver agreement among radiologists when categorizing subsolid nodules using Lung-RADS on LDCT scans.
  • To identify factors influencing the accuracy and consistency of Lung-RADS categorization.

Main Methods:

  • Retrospective review of 162 LDCT scans enriched with subsolid nodules.
  • Categorization of scans by five radiologists using Lung-RADS criteria.
  • Calculation of concordance and discordance rates (minor and major).
  • Analysis of interobserver agreement using Cohen's kappa statistics.

Main Results:

  • Overall accurate Lung-RADS categorization was 60.3% for all cases and 45.0% for positive screens.
  • Minor and major discordance rates were 12.3% and 27.3% overall, respectively.
  • Interobserver agreement was moderate (mean kappa = 0.45).
  • Experienced radiologists demonstrated higher concordance rates compared to residents.
  • A higher proportion of part-solid nodules was associated with lower accurate categorization.

Conclusions:

  • Interobserver agreement in Lung-RADS categorization of subsolid nodules is variable and moderate.
  • Radiologist experience significantly influences the accuracy and consistency of Lung-RADS categorization.
  • The presence of part-solid nodules may contribute to categorization discrepancies, potentially affecting lung cancer screening management recommendations.