肺实性结节半自动体积测量提高观察者间Lung-RADS评分一致性

Semi-automatic volumetry of solid pulmonary nodules improves the interobserver consistency of Lung-RADS score

目的:研究3D-Slicer软件实性肺结节体积测量对不同观察者在肺部影像报告数据系统(lung CT screening reporting and data system,Lung-RADS)分类一致性中的影响。方法:纳入76例患者中的76个实性结节。由3位放射科医师分别采用手动和3D-Slicer软件半自动体积测量方法获得结节的直径与体积,并转化为相应的Lung-RADS评分,其中2分为阴性,3分及以上为阳性。采用同类相关系数(intraclass correlation coefficient,ICC)及Bland-Altman指数来评价观察者间直径与体积测量的一致性,Kappa分析评价观察者间Lung-RADS评分及阳性/阴性组间的一致性。结果:ICC分析结果显示手动直径测量的一致性(0.994~0.996)明显低于半自动体积测量的一致性(0.997~0.998),同时Bland-Altman指数分析结果显示手动直径测量的偏倚高于半自动体积测量。采用半自动体积测量,能够比手动直径测量明显提高观察者间Lung-RADS评分及阳性/阴性之间的一致性(0.963~0.975及0.957~0.977 vs.0.833~0.866及0.863~0.892)。结论:3D-Slicer半自动体积测量能够提高实性肺结节观察者间大小测量的一致性,相应的Lung-RADS分类一致性也随之提高。

Objective:To study the effect of solid pulmonary nodules volume measurement by 3D-Slicer software on the interobserver consistency of lung CT screening reporting and data system(Lung-RADS)categories.Methods:Seventy-six solid nodules from 76 pa⁃tients were included in this study.The diameter and volume of nodules were obtained by three radiologists using manual and 3D-Slicer software semi-automatic volume measurement methods,respectively,and the raw data was converted to the corresponding Lung-RADS score,of which 2 points was negative and 3 points or above was positive.Intraclass correlation coefficient(ICC)and Bland-Altman in⁃dex were used to evaluate the interobserver consistency of diameter and volume measurements.Kappa analysis was used to evaluate the interobserver consistency of Lung-RADS score and the intergroup consistency of positive/negative.Results:ICC analysis showed that the consistency of manual diameter measurement(0.994-0.996)was significantly lower than that of semi-automatic volume measure⁃ment(0.997-0.998),and Bland-Altman index analysis showed that the bias of manual diameter measurement was higher than that of semi-automatic volume measurement.Compared with manual diameter measurement,the use of semi-automatic volume measurement can significantly improve the consistency of Lung-RADS score and positive/negative classifications(0.963-0.975 and 0.957-0.977 vs.0.833-0.866 and 0.863-0.892).Conclusion:3D-Slicer semi-automatic volume measurement can improve the interobserver consis⁃tency of the size measurement of solid pulmonary nodules,as well as the corresponding Lung-RADS categories.