Evaluation of inter-observer variability according to RECIST 1.1 and its influence on response classification in CT measurement of liver metastases |
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| Affiliation: | 1. Department of Radiological Science and Radiation Therapy, IEO European Institute of Oncology, Milan, Italy;2. Department of Oncology, Università degli Studi di Milano, Milan, Italy;3. Università degli Studi di Milano, Postgraduation School in Radiodiagnostics, Milan, Italy;4. New Drugs and Early Drug Development for Innovative Therapies Division, IEO European Institute of Oncology, Milan, Italy;5. Division of Epidemiology and Biostatistics, IEO European Institute of Oncology, Milan, Italy;6. Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia and Division of Radiology, National Center of Oncological Hadrontherapy (CNAO Foundation), Italy;7. Present address: Department of Imaging, CDI Centro Diagnostico Italiano, Via Simone Saint Bon, Milan, Italy;1. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany;2. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA;3. Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy;4. Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;1. Glenfield Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom;2. Heartlands Hospitals, Heart of England NHS foundation Trust, Bordesley Green E, Birmingham B9 5SS, United Kingdom;3. Kettering General Hospital, Treatment Centre, Rothwell Rd, Kettering NN16 8UZ, United Kingdom;4. University Hospital of North Midlands, Newcastle Rd, Stoke-on-Trent, ST4 6QG, United Kingdom;5. Glenfield Hospital, University Hospitals of Leicester, Groby Road Leicester LE3 9QP, United Kingdom;6. Breast Unit, King’s Mill Hospital, Sherwood Forest Hospitals, Sutton-in-Ashfield, Nottinghamshire, NG17 4JL;1. Support Center for Advanced Neuroimaging – Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland;2. Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital, Basel, Switzerland;3. Institute of Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland,;4. Department of Neurosurgery, University Hospital Inselspital and University of Bern, Bern, Switzerland;1. University of Ottawa School of Medicine, 451 Smyth Rd., Ottawa, ON, K1H 8M, Canada;2. The Ottawa Hospital Research Institute Clinical Epidemiology Program, 501 Smyth Rd., Ottawa, ON, K1H 8L6, Canada;1. QIMP group, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;2. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;3. Sensors and Ultrasonics group, Institute of Applied Physics, Vienna University of Technology, Wiedner Hauptstraße 8-10/E134, 1040 Vienna, Austria;1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China;2. Center for Brain Imaging Science and Technology, and Center for Innovative and Collaborative Detection and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, 310027, China;3. College of Civil Aviation, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 210016, China |
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| Abstract: | ![]()
ObjectiveThe aim of this study is the evaluation of inter-observer variability in the measurement of liver metastases according to RECIST and its influence on response classification.Patients and methodsA total of 100 radiologists measured liver target lesions, on pre- and post-chemotherapy CT scans of three patients. Each observer filled out a questionnaire about his personal and work features. The evaluations of a well experienced radiologist, considered as “the gold standard”, were compared to those taken by the observers.The percentage of the observers in agreement with the reviewer, in terms of the response category and in terms of inter-observer variability, was calculated for each patient.ResultsThe percentage of the inter-observer agreement was elevated. Most of the observers in agreement with the reviewer were senior radiologists, while those who disagreed were junior radiologist, but this result did not reach a statistical significance. More than 30% of observers disagreed with the reviewer at least in one of the three cases.ConclusionsRECIST measurements are reproducible on a large and heterogeneous population of radiologists. Age and expertise of the radiologist remain the most critical factors: this suggests a revision by well-experienced radiologists in clinical trials. |
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| Keywords: | Oncology Computed tomography RECIST 1.1 Inter-observer variability |
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