10 July 2018

In Radiology Anton Schreuder et al. showed that experienced radiologists do not agree with each other when classifying nodules on CT as benign perifissural nodules, and that it is unlikely but not impossible that a nodule classified as a perifissural nodule turns out to be a malignant.

Abstract
Purpose To study interreader variability for classifying pulmonary opacities at CT as perifissural nodules (PFNs) and determine how reliably radiologists differentiate PFNs from malignancies. Materials and Methods CT studies were obtained retrospectively from the National Lung Screening Trial (2002-2009). Nodules were eligible for the study if they were noncalcified, solid, within the size range of 5 to 10 mm, and scanned with a section thickness of 2 mm or less. Six radiologists classified 359 nodules in a cancer-enriched data set as PFN, non-PFN, or not applicable. Nodules classified as not applicable by at least three radiologists were excluded, leaving 316 nodules for post-hoc statistical analysis. Results The study group contained 22.2% cancers (70 of 316). The median proportion of nodules classified as PFNs was 45.6% (144 of 316). All six radiologists uniformly classified 17.7% (56 of 316) of the nodules as PFNs. The Fleiss κ was 0.50. Compared with non-PFNs, nodules classified as PFNs were smaller and more often located in the lower lobes and attached to a fissure (P < .001). Thirteen (18.6%) of 70 cancers were misclassified 21 times as PFNs. Individual readers' misclassification rates ranged from 0% (0 of 125) to 4.9% (eight of 163). Of 13 misclassified malignancies, 11 were in the upper lobes and two were attached to a fissure. Conclusion There was moderate interreader agreement when classifying nodules as perifissural nodules. Less than 2.5% of perifissural nodule classifications were misclassified lung cancers (21 of 865) in this cancer-enriched study. Allowing nodules classified as perifissural nodules to be omitted from additional follow-up in a screening setting could substantially reduce the number of unnecessary scans; excluding perifissural nodules in the upper lobes would greatly decrease the misclassification rate.

 
Publication
Classification of CT Pulmonary Opacities as Perifissural Nodules: Reader Variability.
Schreuder A, van Ginneken B, Scholten ET, Jacobs C, Prokop M, Sverzellati N, Desai SR, Devaraj A, Schaefer-Prokop CM.

Anton Schreuder, Bram van Ginneken, Ernst Scholten, Colin Jacobs and Cornelia Schaefer-Prokop are members of theme Rare Cancers. Mathias Prokop is member of theme Vascular damage.

 

Related news items


PhD Networking Days 9 & 10 January 2020 in Milan

21 October 2019

A limited number of places is available at PhD Retreat of research institute in Milan. Travel costs and participation costs are paid for!

read more

Merel Ritskes-Hoitinga has been appointed honorary Skou professor at Aarhus University

17 October 2019

Merel Ritskes-Hoitinga has been appointed honorary Skou Professor at the Dept. of Clinical Medicine, at Aarhus University. The aim is to introduce new perspectives to teaching, strengthen relations with leading research units abroad and establish joint research projects and funding applications.

read more

Call for Meet-the-PhD

16 October 2019

Proud about your work as a PhD candidate? Show first-year bachelor’s students during one week how much fun it is to do research in the activity 'Meet-the-PhD'.

read more

A personal touch of Maroeska te Loo

15 October 2019

In order to promote interaction amongst colleagues within RIMLS, we have a ‘personal touch’ series setting employees in the spotlight. A light-hearted manner to learn about the colleagues you know and those you don’t. This week: Maroeska te Loo.

read more

KWF Roadshow 11 November 2019

10 October 2019

In which way(s) can KWF provide optimal support to oncological research and care? How can we maximize impact on our investments? These questions are pivotal in Ambition 2030: the vision that KWF developed in close cooperation with stakeholders in the oncological field.

read more

More than 3000 visitors at Open Day RIHS

10 October 2019

On Sunday 6 October RIHS organized an Open Day in the Weekend of Science (“Weekend van de Wetenschap”) with special guest and television presenter Klaas van Kruistum. More than 3000 visitors became a health scientist for one day and discovered how special healthcare research is.

read more