Interobserver variability in ct and mr staging of lung cancer

W. Richard Webb, Michele Sarin, Elias A. Zerhouni, Robert T. Heelan, Gary M. Glazer, Constantine Gatsonis

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Objective: Our goal was to assess the interobserver variability in Staging non-small cell lung cancer using CT and MRI. Materials and Methods: As part of the Radiologie Diagnostic Oncology Group (RDOG) study of lung cancer Staging, the CT and MR examinations of 40 patients suspected of having non-small cell bronchogenic carcinoma were blindly interpreted by four expert observers. The primary tumor and lymph node stages in the 40 study subjects were similar to the final proportions reported in the RDOG study. Assessed abnormalities included the presence of a lung nodule, ehest wall invasion, mediastinal invasion, bronchial involvement, lymph node metastasis in specific node stations, and T and N classifications. Percent agreement and K-values were calculated for each of these determinations. Results: Depending on the finding assessed and the method of analysis, average agreement rates ranged from 58 to 90% for CT and from 61 to 96% for MRI. Average K-values were largely between 0.40 and 0.60 when dichotomous analysis was used; weighted K-values were similar. With a single exception, no significant differences were found for K-values calculated for CT and MRI. Conclusion: Although interobserver agreement rates are good for determining T and N Classification in patients with lung cancer, variability in image interpretation is frequent, even among experienced observers.

Original languageEnglish (US)
Pages (from-to)841-846
Number of pages6
JournalJournal of computer assisted tomography
Issue number6
StatePublished - 1993


  • Cancer
  • Comparative studies
  • Comparative studies
  • Computed tomography
  • Lungs
  • Magnetic resonance imaging
  • Neoplasms
  • Staging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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