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Interobserver Variation of Colonic Polyp Measurement at Computed Tomography Colonography
- Source :
- Canadian Association of Radiologists Journal. 70:44-51
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- Background The concept of “advanced polyps” is well accepted and is defined as polyps ≥10 mm and/or those having a villous component and/or demonstrating areas of dysplasia. Of these parameters, computed tomography colonography (CTC) can only document size. The accepted management of CTC-detected “advanced polyps” is to recommend excision if feasible, whereas the management of “intermediate” (6–9 mm) polyps is more controversial, and interval surveillance may be acceptable. Therefore, distinction between 6-9 mm and ≥10 mm is important. Methods Datasets containing 26 polyps originally reported as between 8-12 mm in diameter were reviewed independently by 4 CTC-accredited radiologists. Observers tabulated the largest measurement for each polyp on axial, coronal, sagittal, and endoluminal views at lung-window settings. These measurements were also compared to those determined by the computer-aided detection (CAD) software. Results The interobserver reliability intra-class correlation coefficient (ICC) for sagittal projection was 0.80 (“excellent” category of Hosmer and Lemeshow [2004]), 0.71 for axial (“acceptable”), 0.69 for coronal, and 0.41 for endoluminal (“unacceptable”). The largest of sagittal/axial/coronal measurement gave the best reliability with the smallest variance (ICC = 0.80; 95% CI 0.67–0.89). For 8 of 26 polyps, at least one radiologist's measurement placed the polyp in a different category compared to a colleague. For the majority of the polyps, the CAD significantly overestimated the readings compared to the largest of the manual measurements with an average difference of 1.6 mm ( P < .0001 for sagittal/axial/coronal). This resulted in 33% of polyps falling into a different category—10% were lower and 23% were higher ( P < .034). Conclusion It is apparent that around the cutoff point of 10 mm between “advanced” and “intermediate” polyps, interobserver performance is variable.
- Subjects :
- Virtual colonoscopy
Interobserver reliability
Colon
Colonic Polyps
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Computed Tomography Colonography
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Observer Variation
medicine.diagnostic_test
business.industry
Reproducibility of Results
General Medicine
Colonic Polyp
Sagittal plane
medicine.anatomical_structure
Interobserver Variation
Coronal plane
030211 gastroenterology & hepatology
Cutoff point
business
Nuclear medicine
Colonography, Computed Tomographic
Subjects
Details
- ISSN :
- 14882361 and 08465371
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Canadian Association of Radiologists Journal
- Accession number :
- edsair.doi.dedup.....60498b53ab1a93ed9c7c3ba66f72deda