Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Institute of Medical Imaging, Shanghai, China.
Thorac Cancer. 2017 Sep;8(5):427-435. doi: 10.1111/1759-7714.12458. Epub 2017 Jun 6.
This study was conducted to assess intra-observer and inter-observer agreements for the measurement of dual-input whole tumor computed tomography perfusion (DCTP) in patients with lung cancer.
A total of 88 patients who had undergone DCTP, which had proved a diagnosis of primary lung cancer, were divided into two groups: (i) nodules (diameter ≤3 cm) and masses (diameter >3 cm) by size, and (ii) tumors with and without air density. Pulmonary flow, bronchial flow, and pulmonary index were measured in each group. Intra-observer and inter-observer agreements for measurement were assessed using intraclass correlation coefficient, within-subject coefficient of variation, and Bland-Altman analysis.
In all lung cancers, the reproducibility coefficient for intra-observer agreement (range 26.1-38.3%) was superior to inter-observer agreement (range 38.1-81.2%). Further analysis revealed lower agreements for nodules compared to masses. Additionally, inner-air density reduced both agreements for lung cancer.
The intra-observer agreement for measuring lung cancer DCTP was satisfied, while the inter-observer agreement was limited. The effects of tumoral size and inner-air density to agreements, especially between two observers, should be emphasized. In future, an automatic computer-aided segment of perfusion value of the tumor should be developed.
本研究旨在评估肺癌患者双输入全肿瘤计算机断层灌注（DCTP）测量的观察者内和观察者间一致性。
共有 88 例经 DCTP 证实为原发性肺癌的患者分为两组：（i）大小（直径≤3cm）结节和（直径>3cm）肿块，和（ii）有和无空气密度的肿瘤。在每组中测量肺血流、支气管血流和肺指数。使用组内相关系数、组内变异系数和 Bland-Altman 分析评估测量的观察者内和观察者间一致性。
在所有肺癌中，观察者内一致性的重现系数（范围 26.1-38.3%）优于观察者间一致性（范围 38.1-81.2%）。进一步分析显示，与肿块相比，结节的一致性较低。此外，内空气密度降低了肺癌的两种一致性。
测量肺癌 DCTP 的观察者内一致性令人满意，而观察者间一致性有限。应该强调肿瘤大小和内空气密度对一致性的影响，特别是在两个观察者之间。未来，应该开发一种自动计算机辅助肿瘤灌注值的分割。
