Department of Radiological Science and Radiation Therapy, IEO European Institute of Oncology, Milan, Italy; Department of Oncology, Università degli Studi di Milano, Milan, Italy.
Università degli Studi di Milano, Postgraduation School in Radiodiagnostics, Milan, Italy.
Eur J Radiol. 2017 Oct;95:96-101. doi: 10.1016/j.ejrad.2017.08.001. Epub 2017 Aug 4.
The 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.
A 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.
The 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.
RECIST 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.
本研究旨在评估根据 RECIST 对肝脏转移瘤进行测量的观察者间变异性及其对反应分类的影响。
共 100 名放射科医生测量了三位患者化疗前后 CT 扫描的肝脏靶病灶。每位观察者填写了一份关于其个人和工作特征的问卷。将一位经验丰富的放射科医生的评估结果（被视为“金标准”）与观察者的评估结果进行比较。对于每位患者，计算观察者与评审员在反应类别和观察者间变异性方面的一致率。
观察者间的一致性百分比较高。大多数与评审员意见一致的观察者是资深放射科医生，而那些意见不一致的则是初级放射科医生，但这一结果并未达到统计学意义。超过 30%的观察者在至少三个病例中与评审员意见不一致。
RECISt 测量在大量和异质的放射科医生群体中具有可重复性。放射科医生的年龄和专业知识仍然是最关键的因素：这表明在临床试验中需要由经验丰富的放射科医生进行修订。
