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Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers using multi-detector row CT
Purpose To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT). Methods This retrospective study included 151 patients with surgically confirmed T1 ( n = 49)- or T2 ( n = 102)-stage GB cancer wh...
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| Published in: | Abdominal imaging 2022-04, Vol.47 (4), p.1341-1350 |
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| creator | Kwon, Yong Jae Song, Kyoung Doo Ko, Seong Eun Hwang, Jeong Ah Kim, Minji |
| description | Purpose
To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT).
Methods
This retrospective study included 151 patients with surgically confirmed T1 (
n
= 49)- or T2 (
n
= 102)-stage GB cancer who underwent contrast-enhanced MDCT from 2016 to 2020. Five radiologists (two experienced and three less experienced) evaluated the T-stage with a confidence level calculated using a six-point scale. GB cancers were morphologically classified into three types: polypoid, polypoid with wall thickening, and wall thickening. The diagnostic performance of T-staging was assessed using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated based on a binary scale (T1 = positive). Inter-observer agreement was assessed using Fleiss κ statistics.
Results
The area under the receiver operating characteristic (ROC) curve of each reviewer for T-staging ranged from 0.69 to 0.80 (median 0.77). The overall accuracy of the five radiologists was 78% (95% confidence interval [CI] 71–84%). Sensitivity was higher and specificity was lower in experienced radiologists than in less experienced radiologists (
P
|
| doi_str_mv | 10.1007/s00261-022-03450-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2631863447</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2631863447</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-8b15fdff9cbb8efc750ff1ab17e4c3ea81a534b5b35f03dd4a97c57719b76cfb3</originalsourceid><addsrcrecordid>eNp9kctqHDEQRZuQEBvHP-BFEGSTjRI9Wz3LMHk4YPBmvBZ6lBqZbmkiqW38Ff7ltD12ErLwSgU691TB7bozSj5RQtTnSgjrKSaMYcKFJJi_6o4Z73tMiBxe_zMfdae1XhNCaC8pZfJtd8Ql3TAixHF3_zWaMeXaokN7KCGX2SQHyCSPYmpQcLYVyg0UdGNKNDZOsd2hlpGPIUCB1KJpgCy0W4CEdhQ_ZncM12ZGQKOZJjsZ71eDe1CXipYa04jmZWoRe2jgWi6o5Fu03b3r3gQzVTh9ek-6q-_fdttzfHH54-f2ywV2XMmGB0tl8CFsnLUDBKckCYEaSxUIx8EM1EgurLRcBsK9F2ajnFSKbqzqXbD8pPt48O5L_rVAbXqO1cE0mQR5qZr1nA49F0Kt6If_0Ou8lLRet1KCyJ5JwVaKHShXcq0Fgt6XOJtypynRD43pQ2N6bUw_Nqb5Gnr_pF7sDP5P5LmfFeAHoK5faYTyd_cL2t_tEqMf</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2640562542</pqid></control><display><type>article</type><title>Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers using multi-detector row CT</title><source>Springer Nature</source><creator>Kwon, Yong Jae ; Song, Kyoung Doo ; Ko, Seong Eun ; Hwang, Jeong Ah ; Kim, Minji</creator><creatorcontrib>Kwon, Yong Jae ; Song, Kyoung Doo ; Ko, Seong Eun ; Hwang, Jeong Ah ; Kim, Minji</creatorcontrib><description>Purpose
To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT).
Methods
This retrospective study included 151 patients with surgically confirmed T1 (
n
= 49)- or T2 (
n
= 102)-stage GB cancer who underwent contrast-enhanced MDCT from 2016 to 2020. Five radiologists (two experienced and three less experienced) evaluated the T-stage with a confidence level calculated using a six-point scale. GB cancers were morphologically classified into three types: polypoid, polypoid with wall thickening, and wall thickening. The diagnostic performance of T-staging was assessed using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated based on a binary scale (T1 = positive). Inter-observer agreement was assessed using Fleiss κ statistics.
Results
The area under the receiver operating characteristic (ROC) curve of each reviewer for T-staging ranged from 0.69 to 0.80 (median 0.77). The overall accuracy of the five radiologists was 78% (95% confidence interval [CI] 71–84%). Sensitivity was higher and specificity was lower in experienced radiologists than in less experienced radiologists (
P
< 0.001). The overall inter-observer agreement was fair (
κ
= 0.36; 95% CI 0.31, 0.41). The overall accuracy for T-stage was 63% (95% CI 48–76), 78% (95% CI 63–88), and 87% (95% CI 77–93) for polypoid, polypoid with wall thickening, and wall thickening type, respectively.
Conclusion
The accuracy of MDCT for differentiating T1 and T2 GB cancer is limited, and there is considerable inter-observer variability.</description><identifier>ISSN: 2366-0058</identifier><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-022-03450-3</identifier><identifier>PMID: 35192044</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Accuracy ; Cancer ; Confidence intervals ; Diagnostic systems ; Gallbladder ; Gallbladder cancer ; Gallbladder Neoplasms - diagnostic imaging ; Gastroenterology ; Hepatobiliary ; Hepatology ; Humans ; Imaging ; Mathematical analysis ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Observer Variation ; Performance evaluation ; Radiology ; Retrospective Studies ; ROC Curve ; Sensitivity analysis ; Sensitivity and Specificity ; Statistical analysis ; Thickening ; Tomography, X-Ray Computed ; Variability</subject><ispartof>Abdominal imaging, 2022-04, Vol.47 (4), p.1341-1350</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-8b15fdff9cbb8efc750ff1ab17e4c3ea81a534b5b35f03dd4a97c57719b76cfb3</citedby><cites>FETCH-LOGICAL-c375t-8b15fdff9cbb8efc750ff1ab17e4c3ea81a534b5b35f03dd4a97c57719b76cfb3</cites><orcidid>0000-0002-2767-3622</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35192044$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kwon, Yong Jae</creatorcontrib><creatorcontrib>Song, Kyoung Doo</creatorcontrib><creatorcontrib>Ko, Seong Eun</creatorcontrib><creatorcontrib>Hwang, Jeong Ah</creatorcontrib><creatorcontrib>Kim, Minji</creatorcontrib><title>Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers using multi-detector row CT</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT).
Methods
This retrospective study included 151 patients with surgically confirmed T1 (
n
= 49)- or T2 (
n
= 102)-stage GB cancer who underwent contrast-enhanced MDCT from 2016 to 2020. Five radiologists (two experienced and three less experienced) evaluated the T-stage with a confidence level calculated using a six-point scale. GB cancers were morphologically classified into three types: polypoid, polypoid with wall thickening, and wall thickening. The diagnostic performance of T-staging was assessed using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated based on a binary scale (T1 = positive). Inter-observer agreement was assessed using Fleiss κ statistics.
Results
The area under the receiver operating characteristic (ROC) curve of each reviewer for T-staging ranged from 0.69 to 0.80 (median 0.77). The overall accuracy of the five radiologists was 78% (95% confidence interval [CI] 71–84%). Sensitivity was higher and specificity was lower in experienced radiologists than in less experienced radiologists (
P
< 0.001). The overall inter-observer agreement was fair (
κ
= 0.36; 95% CI 0.31, 0.41). The overall accuracy for T-stage was 63% (95% CI 48–76), 78% (95% CI 63–88), and 87% (95% CI 77–93) for polypoid, polypoid with wall thickening, and wall thickening type, respectively.
Conclusion
The accuracy of MDCT for differentiating T1 and T2 GB cancer is limited, and there is considerable inter-observer variability.</description><subject>Accuracy</subject><subject>Cancer</subject><subject>Confidence intervals</subject><subject>Diagnostic systems</subject><subject>Gallbladder</subject><subject>Gallbladder cancer</subject><subject>Gallbladder Neoplasms - diagnostic imaging</subject><subject>Gastroenterology</subject><subject>Hepatobiliary</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Mathematical analysis</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Observer Variation</subject><subject>Performance evaluation</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity analysis</subject><subject>Sensitivity and Specificity</subject><subject>Statistical analysis</subject><subject>Thickening</subject><subject>Tomography, X-Ray Computed</subject><subject>Variability</subject><issn>2366-0058</issn><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kctqHDEQRZuQEBvHP-BFEGSTjRI9Wz3LMHk4YPBmvBZ6lBqZbmkiqW38Ff7ltD12ErLwSgU691TB7bozSj5RQtTnSgjrKSaMYcKFJJi_6o4Z73tMiBxe_zMfdae1XhNCaC8pZfJtd8Ql3TAixHF3_zWaMeXaokN7KCGX2SQHyCSPYmpQcLYVyg0UdGNKNDZOsd2hlpGPIUCB1KJpgCy0W4CEdhQ_ZncM12ZGQKOZJjsZ71eDe1CXipYa04jmZWoRe2jgWi6o5Fu03b3r3gQzVTh9ek-6q-_fdttzfHH54-f2ywV2XMmGB0tl8CFsnLUDBKckCYEaSxUIx8EM1EgurLRcBsK9F2ajnFSKbqzqXbD8pPt48O5L_rVAbXqO1cE0mQR5qZr1nA49F0Kt6If_0Ou8lLRet1KCyJ5JwVaKHShXcq0Fgt6XOJtypynRD43pQ2N6bUw_Nqb5Gnr_pF7sDP5P5LmfFeAHoK5faYTyd_cL2t_tEqMf</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Kwon, Yong Jae</creator><creator>Song, Kyoung Doo</creator><creator>Ko, Seong Eun</creator><creator>Hwang, Jeong Ah</creator><creator>Kim, Minji</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2767-3622</orcidid></search><sort><creationdate>20220401</creationdate><title>Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers using multi-detector row CT</title><author>Kwon, Yong Jae ; Song, Kyoung Doo ; Ko, Seong Eun ; Hwang, Jeong Ah ; Kim, Minji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-8b15fdff9cbb8efc750ff1ab17e4c3ea81a534b5b35f03dd4a97c57719b76cfb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>Cancer</topic><topic>Confidence intervals</topic><topic>Diagnostic systems</topic><topic>Gallbladder</topic><topic>Gallbladder cancer</topic><topic>Gallbladder Neoplasms - diagnostic imaging</topic><topic>Gastroenterology</topic><topic>Hepatobiliary</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Mathematical analysis</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Observer Variation</topic><topic>Performance evaluation</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity analysis</topic><topic>Sensitivity and Specificity</topic><topic>Statistical analysis</topic><topic>Thickening</topic><topic>Tomography, X-Ray Computed</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kwon, Yong Jae</creatorcontrib><creatorcontrib>Song, Kyoung Doo</creatorcontrib><creatorcontrib>Ko, Seong Eun</creatorcontrib><creatorcontrib>Hwang, Jeong Ah</creatorcontrib><creatorcontrib>Kim, Minji</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - 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Academic</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kwon, Yong Jae</au><au>Song, Kyoung Doo</au><au>Ko, Seong Eun</au><au>Hwang, Jeong Ah</au><au>Kim, Minji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers using multi-detector row CT</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>47</volume><issue>4</issue><spage>1341</spage><epage>1350</epage><pages>1341-1350</pages><issn>2366-0058</issn><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT).
Methods
This retrospective study included 151 patients with surgically confirmed T1 (
n
= 49)- or T2 (
n
= 102)-stage GB cancer who underwent contrast-enhanced MDCT from 2016 to 2020. Five radiologists (two experienced and three less experienced) evaluated the T-stage with a confidence level calculated using a six-point scale. GB cancers were morphologically classified into three types: polypoid, polypoid with wall thickening, and wall thickening. The diagnostic performance of T-staging was assessed using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated based on a binary scale (T1 = positive). Inter-observer agreement was assessed using Fleiss κ statistics.
Results
The area under the receiver operating characteristic (ROC) curve of each reviewer for T-staging ranged from 0.69 to 0.80 (median 0.77). The overall accuracy of the five radiologists was 78% (95% confidence interval [CI] 71–84%). Sensitivity was higher and specificity was lower in experienced radiologists than in less experienced radiologists (
P
< 0.001). The overall inter-observer agreement was fair (
κ
= 0.36; 95% CI 0.31, 0.41). The overall accuracy for T-stage was 63% (95% CI 48–76), 78% (95% CI 63–88), and 87% (95% CI 77–93) for polypoid, polypoid with wall thickening, and wall thickening type, respectively.
Conclusion
The accuracy of MDCT for differentiating T1 and T2 GB cancer is limited, and there is considerable inter-observer variability.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35192044</pmid><doi>10.1007/s00261-022-03450-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2767-3622</orcidid></addata></record> |
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| identifier | ISSN: 2366-0058 |
| ispartof | Abdominal imaging, 2022-04, Vol.47 (4), p.1341-1350 |
| issn | 2366-0058 2366-004X 2366-0058 |
| language | eng |
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| source | Springer Nature |
| subjects | Accuracy Cancer Confidence intervals Diagnostic systems Gallbladder Gallbladder cancer Gallbladder Neoplasms - diagnostic imaging Gastroenterology Hepatobiliary Hepatology Humans Imaging Mathematical analysis Medical diagnosis Medicine Medicine & Public Health Observer Variation Performance evaluation Radiology Retrospective Studies ROC Curve Sensitivity analysis Sensitivity and Specificity Statistical analysis Thickening Tomography, X-Ray Computed Variability |
| title | Diagnostic performance and inter-observer variability to differentiate between T1- and T2-stage gallbladder cancers using multi-detector row CT |
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