Cancer Imaging (Nov 2019)

Lesion measurement on a combined “all-in-one” window for chest CT: effect on intra- and interobserver variability

  • Annemiek Snoeckx,
  • Jeroen Cant,
  • Caro Franck,
  • Elisa Luyckx,
  • Ken Carpentier,
  • Simon Nicolay,
  • Astrid Van Hoyweghen,
  • Maarten J. Spinhoven,
  • Pieter Vuylsteke,
  • Paul M. Parizel

DOI
https://doi.org/10.1186/s40644-019-0262-0
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 9

Abstract

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Abstract Purpose A newly developed image processing technique fuses conventional windows into a single ‘All-In-One’ (AIO) window. This study aims to evaluate variability of CT measurement of lesions in thoracic oncology patients on this novel AIO-window. Methods Six radiologists with different levels of expertise measured 368 lesions of various size, origin and sharpness. All lesions were measured twice on the AIO-window and twice on the conventional window settings. Intraclass correlation coefficients and Bland-Altman plots were used to assess intra- and interobserver variability. Results Overall intra-observer agreement for lesion diameters on the AIO-window and conventional window settings was 0.986 (95% Confidence interval (CI): 0.983–0.989) and 0.991 (95% CI 0.989–0.993) respectively. For interobserver agreement this was 0.982 (95% CI 0.979–0.985) (AIO) and 0.979 (95% CI 0.957–0.982) (conventional). For both the AIO and conventional windows, intra- and interobserver agreement were dependent on size, sharpness and reader experience. Measurement variability decreased with increasing lesion size. Regarding sharpness, inter- and intra-observer agreement ranged from 0.986–0.989 (AIO) and 0.985–0.992 (conventional) for well-defined lesions and from 0.978–0.983 (AIO) and 0.974–0.991 (conventional) for ill-defined lesions. Conclusions Lesion diameters were consistently smaller on the AIO-window compared to conventional window settings. Overall intra- and interobserver variability rates were similar for the AIO-window and conventional window settings. We conclude that the AIO-window offers a reliable and reproducible alternative for measurement of thoracic lesions.

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