Department of Radiology, Antwerp University Hospital and University of Antwerp, 2650 Edegem, Belgium.
Agfa Medical Imaging, 2640 Mortsel, Belgium.
Diagn Interv Imaging. 2020 Jan;101(1):25-33. doi: 10.1016/j.diii.2019.07.009. Epub 2019 Aug 8.
The purpose of this study was to investigate if lesion detection using a single "All-in-One" (AIO) window was non-inferior to lesion detection on conventional window settings in thoracic oncology chest computed tomography (CT) examinations.
In a retrospective study, 50 consecutive chest CT examinations of 50 patients (31 men, 19 women; mean age 64±10 [SD] years, range: 35-82 years) containing 417 lesions, were reviewed by 6 radiologists, subdivided into 2 groups of 3 radiologists each, with similar levels of expertise in each group (senior staff member, junior staff member and radiology resident). All examinations were reviewed in conventional or AIO window settings by one of the groups. A 'lesion' was defined as any abnormality seen on the chest CT examination, including both benign and malignant lesions, findings in chest and upper abdomen, and measurable and non-measurable disease. Lesions were listed as 'missed' when they were not seen by at least two out of three observers. F-tests were used to evaluate the significance of the variables of interest within a mixed model framework and kappa statistics to report interobserver agreement.
On a reader level, 54/417 lesions (12.9%) were not detected by the senior staff member reading the studies in conventional window settings and 45/417 (10.8%) by the senior staff member reading the AIO images. For the junior staff member and radiology resident this was respectively 55/417 (13.2%) and 67/417 (16.1%) for the conventional window settings and 43/417 (10.3%) and 61/417 (14.6%) for the AIO window. On a lesion level, 68/417 (16.3%) were defined as 'missed' lesions (lesions not detected by at least 2 readers): 21/68 (30.9%) on the AIO-window, 30/68 (44.1%) on conventional views and 17/68 (25.0%) on both views. The use of the AIO window did not result in an increase of missed lesions (P>0.99). Interobserver agreement in both groups was similar (P=0.46). Regarding lesions that were categorized as 'missed' on the AIO window or on conventional window settings, there was no effect of location (chest or upper abdomen) (P=0.35), window (P=0.97) and organ (P=0.98).
A single AIO-window is non-inferior to multiple conventional window settings for lesion detection on chest CT examinations in thoracic oncology patients.
本研究旨在探讨在胸部肿瘤 CT 检查中，使用单个“All-in-One”（AIO）窗口进行病变检测是否不劣于传统窗口设置的病变检测。
在一项回顾性研究中，50 名连续的胸部 CT 检查的 50 名患者（31 名男性，19 名女性；平均年龄 64±10[SD]岁，范围：35-82 岁），共包含 417 个病变，由 6 名放射科医生进行了回顾，分为两组，每组 3 名医生，每组的专业水平相似（高级职员、初级职员和放射科住院医师）。所有检查均在常规或 AIO 窗口设置下由其中一组进行。“病变”定义为胸部 CT 检查中所见的任何异常，包括良性和恶性病变、胸部和上腹部的发现以及可测量和不可测量的疾病。当至少有 3 名观察者中的 2 名未观察到病变时，将其列为“遗漏”。F 检验用于在混合模型框架内评估感兴趣变量的显著性，kappa 统计用于报告观察者间的一致性。
在读者层面上，54/417（12.9%）个病变被阅读常规窗口设置的高级职员遗漏，45/417（10.8%）个病变被阅读 AIO 图像的高级职员遗漏。对于初级职员和放射科住院医师，在常规窗口设置下分别为 55/417（13.2%）和 67/417（16.1%），在 AIO 窗口下分别为 43/417（10.3%）和 61/417（14.6%）。在病变层面上，68/417（16.3%）被定义为“遗漏”病变（至少有 2 名观察者未检测到的病变）：21/68（30.9%）在 AIO 窗口，30/68（44.1%）在常规视图，17/68（25.0%）在两者。使用 AIO 窗口不会导致遗漏病变的增加（P>0.99）。两组观察者间的一致性相似（P=0.46）。对于在 AIO 窗口或常规窗口设置上被归类为“遗漏”的病变，位置（胸部或上腹部）（P=0.35）、窗口（P=0.97）和器官（P=0.98）均无影响。
在胸部肿瘤患者的胸部 CT 检查中，单个 AIO 窗口在病变检测方面不劣于多个传统窗口设置。
