Zappa Magaly, Hentic Olivia, Vullierme Marie-Pierre, Lagadec Matthieu, Ronot Maxime, Ruszniewski Philippe, Vilgrain Valérie
Univ Paris DiderotSorbonne Paris Cité, Paris, France
INSERMUMR1149 CRI, Paris, France.
Endocr Connect. 2017 Jan;6(1):33-38. doi: 10.1530/EC-16-0092. Epub 2017 Jan 9.
Visual semi-quantitative assessment of liver tumour burden for neuroendocrine tumour liver metastases is often used in patient management and outcome. However, published data on the reproducibility of these evaluations are lacking.
The aim of this study was to evaluate the interobserver and intraobserver agreement of a visual semi-quantitative assessment of liver tumour burden using CT scan.
Fifty consecutive patients (24 men and 26 women, mean aged 54 years) were retrospectively reviewed by four readers (two senior radiologists, one junior radiologist and one gastroenterologist) who assessed the liver tumour burden based on a visual semi-quantitative method with four classes (0-10, 11-25, 26-50 and ≥50%). Interobserver and intraobserver agreement were assessed by weighted kappa coefficient and percentage of agreement. The intraclass correlation was calculated.
Agreement among the four observers for the evaluation of liver tumour burden was substantial, ranging from 0.62 to 0.73 (P < 0.0001). The intraclass coefficient was 0.977 (P < 0.0001). Intraobserver agreement was 0.78 and ICC was 0.97.
Reproducibility of the visual semi-quantitative evaluation of liver tumour burden is good and is independent of the level of experience of the readers. We therefore suggest that clinical studies in patients with neuroendocrine liver metastases use this method to categorise liver tumour burden.
对于神经内分泌肿瘤肝转移患者，肝脏肿瘤负荷的视觉半定量评估常用于患者管理及预后判断。然而，关于这些评估的可重复性的已发表数据尚缺。
本研究旨在评估使用CT扫描对肝脏肿瘤负荷进行视觉半定量评估时观察者间及观察者内的一致性。
连续纳入50例患者（24例男性，26例女性，平均年龄54岁），由四位阅片者（两位资深放射科医生、一位初级放射科医生和一位胃肠病学家）进行回顾性分析，他们基于视觉半定量方法将肝脏肿瘤负荷分为四类（0 - 10%、11 - 25%、26 - 50%和≥50%）进行评估。通过加权kappa系数和一致性百分比评估观察者间及观察者内的一致性。计算组内相关系数。
四位观察者对肝脏肿瘤负荷评估的一致性较高，范围为0.62至0.73（P < 0.0001）。组内系数为0.977（P < 0.0001）。观察者内一致性为0.78，组内相关系数为0.97。
肝脏肿瘤负荷视觉半定量评估的可重复性良好，且与阅片者的经验水平无关。因此，我们建议神经内分泌肝转移患者的临床研究采用此方法对肝脏肿瘤负荷进行分类。
