Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume

Background: This study aimed to assess the interobserver variability of semi-automatic diameter and volumetric measurements versus manual diameter measurements for small lung nodules identified on computed tomography scans. Methods: The radiological patient database was searched for CT thorax examin...

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Main Authors: Frida Zacharias, Tony Martin Svahn
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Tomography
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Online Access:https://www.mdpi.com/2379-139X/10/12/148
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author Frida Zacharias
Tony Martin Svahn
author_facet Frida Zacharias
Tony Martin Svahn
author_sort Frida Zacharias
collection DOAJ
description Background: This study aimed to assess the interobserver variability of semi-automatic diameter and volumetric measurements versus manual diameter measurements for small lung nodules identified on computed tomography scans. Methods: The radiological patient database was searched for CT thorax examinations with at least one noncalcified solid nodule (∼3–10 mm). Three radiologists with four to six years of experience evaluated each nodule in accordance with the Fleischner Society guidelines using standard diameter measurements, semi-automatic lesion diameter measurements, and volumetric assessments. Spearman’s correlation coefficient measured intermeasurement agreement. We used descriptive Bland–Altman plots to visualize agreement in the measured data. Potential discrepancies were analyzed. Results: We studied a total of twenty-six nodules. Spearman’s test showed that there was a much stronger relationship (<i>p</i> < 0.05) between reviewers for the semi-automatic diameter and volume measurements (avg. r = 0.97 ± 0.017 and 0.99 ± 0.005, respectively) than for the manual method (avg. r = 0.91 ± 0.017). In the Bland–Altman test, the semi-automatic diameter measure outperformed the manual method for all comparisons, while the volumetric method had better results in two out of three comparisons. The incidence of reviewers modifying the software’s automatic outline varied between 62% and 92%. Conclusions: Semi-automatic techniques significantly reduced interobserver variability for small solid nodules, which has important implications for diagnostic assessments and screening. Both the semi-automatic diameter and semi-automatic volume measurements showed improvements over the manual measurement approach. Training could further diminish observer variability, given the considerable diversity in the number of adjustments among reviewers.
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spelling doaj-art-89a9f6eec2e543b7b9a9e18c0ce2e8de2025-08-20T02:57:29ZengMDPI AGTomography2379-13812379-139X2024-12-0110122087209910.3390/tomography10120148Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and VolumeFrida Zacharias0Tony Martin Svahn1Department of Imaging and Functional Medicine, Division Diagnostics, Hudiksvall Hospital, Region Gävleborg, SE 824 81 Hudiksvall, SwedenCentre for Research and Development, Uppsala University, Region Gävleborg, SE 801 88 Gävle, SwedenBackground: This study aimed to assess the interobserver variability of semi-automatic diameter and volumetric measurements versus manual diameter measurements for small lung nodules identified on computed tomography scans. Methods: The radiological patient database was searched for CT thorax examinations with at least one noncalcified solid nodule (∼3–10 mm). Three radiologists with four to six years of experience evaluated each nodule in accordance with the Fleischner Society guidelines using standard diameter measurements, semi-automatic lesion diameter measurements, and volumetric assessments. Spearman’s correlation coefficient measured intermeasurement agreement. We used descriptive Bland–Altman plots to visualize agreement in the measured data. Potential discrepancies were analyzed. Results: We studied a total of twenty-six nodules. Spearman’s test showed that there was a much stronger relationship (<i>p</i> < 0.05) between reviewers for the semi-automatic diameter and volume measurements (avg. r = 0.97 ± 0.017 and 0.99 ± 0.005, respectively) than for the manual method (avg. r = 0.91 ± 0.017). In the Bland–Altman test, the semi-automatic diameter measure outperformed the manual method for all comparisons, while the volumetric method had better results in two out of three comparisons. The incidence of reviewers modifying the software’s automatic outline varied between 62% and 92%. Conclusions: Semi-automatic techniques significantly reduced interobserver variability for small solid nodules, which has important implications for diagnostic assessments and screening. Both the semi-automatic diameter and semi-automatic volume measurements showed improvements over the manual measurement approach. Training could further diminish observer variability, given the considerable diversity in the number of adjustments among reviewers.https://www.mdpi.com/2379-139X/10/12/148interobserver variabilitysemi-automatic measurementcomputed tomography (CT)lung nodule size
spellingShingle Frida Zacharias
Tony Martin Svahn
Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume
Tomography
interobserver variability
semi-automatic measurement
computed tomography (CT)
lung nodule size
title Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume
title_full Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume
title_fullStr Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume
title_full_unstemmed Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume
title_short Interobserver Variability in Manual Versus Semi-Automatic CT Assessments of Small Lung Nodule Diameter and Volume
title_sort interobserver variability in manual versus semi automatic ct assessments of small lung nodule diameter and volume
topic interobserver variability
semi-automatic measurement
computed tomography (CT)
lung nodule size
url https://www.mdpi.com/2379-139X/10/12/148
work_keys_str_mv AT fridazacharias interobservervariabilityinmanualversussemiautomaticctassessmentsofsmalllungnodulediameterandvolume
AT tonymartinsvahn interobservervariabilityinmanualversussemiautomaticctassessmentsofsmalllungnodulediameterandvolume