Effectiveness of radiologist training in improving reader agreement for Lung-RADS 4X categorization
- Authors
- Kim, Hyungjin; Goo, Jin Mo; Kim, Tae Jung; Kim, Hyae Young; Gu, Guanmin; Gil, Bomi; Kim, Wooil; Park, Seon Young; Park, Junghoan; Park, Juil; Park, Harkhoon; Song, Wonkyu; Shin, Kyung Eun; Oh, Jiseon; Yoon, Sung Hyun; Lee, Sanghyup; Lee, Youkyung; Lim, Woo Hyeon; Jeong, Won Gi; Jung, Jung Im; Cha, Min Jae; Choi, Sinae; Choi, Hyoung In; Ham, Soo-Youn; Kim, Yeol
- Issue Date
- Nov-2021
- Publisher
- SPRINGER
- Keywords
- Early detection of cancer; Diagnostic screening programs; Lung neoplasms; Multidetector computed tomography
- Citation
- EUROPEAN RADIOLOGY, v.31, no.11, pp.8147 - 8159
- Indexed
- SCIE
SCOPUS
- Journal Title
- EUROPEAN RADIOLOGY
- Volume
- 31
- Number
- 11
- Start Page
- 8147
- End Page
- 8159
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/140597
- DOI
- 10.1007/s00330-021-07990-y
- ISSN
- 0938-7994
- Abstract
- Objectives To identify the agreement on Lung CT Screening Reporting and Data System 4X categorization between radiologists and an expert-adjudicated reference standard and to investigate whether training led to improvement of the agreement measures and diagnostic potential for lung cancer. Methods Category 4 nodules in the Korean Lung Cancer Screening Project were identified retrospectively, and each 4X nodule was matched with one 4A or 4B nodule. An expert panel re-evaluated the categories and determined the reference standard. Nineteen radiologists were asked to determine the presence of CT features of malignancy and 4X categorization for each nodule. A review was performed in two sessions, and training material was given after session 1. Agreement on 4X categorization between radiologists and the expert-adjudicated reference standard and agreement between radiologist-assessed 4X categorization and lung cancer diagnosis were evaluated. Results The 48 expert-adjudicated 4X nodules and 64 non-4X nodules were evenly distributed in each session. The proportion of category 4X decreased after training (56.4% +/- 16.9% vs. 33.4% +/- 8.0%; p < 0.001). Cohen's kappa indicated poor agreement (0.39 +/- 0.16) in session 1, but agreement improved in session 2 (0.47 +/- 0.09; p = 0.03). The increase in agreement in session 2 was observed among inexperienced radiologists (p < 0.05), and experienced and inexperienced reviewers exhibited comparable agreement performance in session 2 (p > 0.05). All agreement measures between radiologist-assessed 4X categorization and lung cancer diagnosis increased in session 2 (p < 0.05). Conclusion Radiologist training can improve reader agreement on 4X categorization, leading to enhanced diagnostic performance for lung cancer.
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