Nodule Classification on Low-Dose Unenhanced CT and Standard-Dose Enhanced CT: Inter-Protocol Agreement and Analysis of Interchangeability.

Abstract:

Objective:To measure inter-protocol agreement and analyze interchangeability on nodule classification between low-dose unenhanced CT and standard-dose enhanced CT. Materials and Methods:From nodule libraries containing both low-dose unenhanced and standard-dose enhanced CT, 80 solid and 80 subsolid (40 part-solid, 40 non-solid) nodules of 135 patients were selected. Five thoracic radiologists categorized each nodule into solid, part-solid or non-solid. Inter-protocol agreement between low-dose unenhanced and standard-dose enhanced images was measured by pooling κ values for classification into two (solid, subsolid) and three (solid, part-solid, non-solid) categories. Interchangeability between low-dose unenhanced and standard-dose enhanced CT for the classification into two categories was assessed using a pre-defined equivalence limit of 8 percent. Results:Inter-protocol agreement for the classification into two categories {κ, 0.96 (95% confidence interval [CI], 0.94-0.98)} and that into three categories (κ, 0.88 [95% CI, 0.85-0.92]) was considerably high. The probability of agreement between readers with standard-dose enhanced CT was 95.6% (95% CI, 94.5-96.6%), and that between low-dose unenhanced and standard-dose enhanced CT was 95.4% (95% CI, 94.7-96.0%). The difference between the two proportions was 0.25% (95% CI, -0.85-1.5%), wherein the upper bound CI was markedly below 8 percent. Conclusion:Inter-protocol agreement for nodule classification was considerably high. Low-dose unenhanced CT can be used interchangeably with standard-dose enhanced CT for nodule classification.

journal_name

Korean J Radiol

authors

Lee KH,Lee KW,Park JH,Han K,Kim J,Lee SM,Park CM

doi

10.3348/kjr.2018.19.3.516

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

516-525

issue

3

eissn

1229-6929

issn

2005-8330

journal_volume

19

pub_type

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