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The clinical impact of observer variability in lung nodule classification in children with Wilms tumour.
Brok, Jesper Sune; Shelmerdine, Susan; Damsgaard, Frederikke; Smets, Anne; Irtan, Sabine; Swinson, Sophie; Hedayati, Venus; Jacob, Joseph; Nair, Arjun; Oostveen, Minou; Pritchard-Jones, Kathy; Olsen, Øystein.
Afiliación
  • Brok JS; Department of Paediatric Haematology and Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Shelmerdine S; UCL Great Ormond Street Institute of Child Health, London, UK.
  • Damsgaard F; Department of Clinical Radiology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
  • Smets A; UCL Great Ormond Street Institute of Child Health, London, UK.
  • Irtan S; Department of Paediatric Haematology and Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Swinson S; Department of Radiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
  • Hedayati V; Department of Visceral and Neonatal Paediatric Surgery, Sorbonne University, Armand Trousseau Hospital - APHP, Paris, France.
  • Jacob J; The Leeds Teaching Hospitals, Leeds, UK.
  • Nair A; King's College Hospital NHS Foundation Trust, London, UK.
  • Oostveen M; Centre for Medical Image Computing, University College London, London, UK.
  • Pritchard-Jones K; Department of Respiratory Medicine, University College London, London, UK.
  • Olsen Ø; University College London Hospitals NHS Foundation Trust, London, UK.
Pediatr Blood Cancer ; 69(10): e29759, 2022 10.
Article en En | MEDLINE | ID: mdl-35652617
OBJECTIVES: To investigate the extent to which observer variability of computed tomography (CT) lung nodule assessment may affect clinical treatment stratification in Wilms tumour (WT) patients, according to the recent Société Internationale d'Oncologie Pédiatrique Renal Tumour Study Group (SIOP-RTSG) UMBRELLA protocol. METHODS: I: CT thoraces of children with WT submitted for central review were used to estimate size distribution of lung metastases. II: Scans were selected for blinded review by five radiologists to determine intra- and inter-observer variability. They assessed identical scans on two occasions 6 months apart. III: Monte Carlo simulation (MCMC) was used to predict the clinical impact of observer variation when applying the UMBRELLA protocol size criteria. RESULTS: Lung nodules were found in 84 out of 360 (23%) children with WT. For 21 identified lung nodules, inter-observer limits of agreement (LOA) for the five readers were ±2.4 and ±1.4 mm (AP diameter), ±1.9 and ±1.8 mm (TS diameter) and ±2.0 and ±2.4 mm (LS diameter) at assessments 1 and 2. Intra-observer LOA across the three dimensions were ±1.5, ±2.2, ±3.5, ±3.1 and ±2.6 mm (readers 1-5). MCMC demonstrated that 17% of the patients with a 'true' nodule size of ≥3 mm will be scored as <3 mm, and 21% of the patients with a 'true' nodule size of <3 mm will be scored as being ≥3 mm. CONCLUSION: A significant intra-inter observer variation was found when measuring lung nodules on CT for patients with WT. This may have significant implications on treatment stratification, and thereby outcome, when applying a threshold of ≥3 mm for a lung nodule to dictate metastatic status.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tumor de Wilms / Neoplasias Renales / Neoplasias Pulmonares Tipo de estudio: Guideline / Prognostic_studies Límite: Child / Humans Idioma: En Revista: Pediatr Blood Cancer Asunto de la revista: HEMATOLOGIA / NEOPLASIAS / PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tumor de Wilms / Neoplasias Renales / Neoplasias Pulmonares Tipo de estudio: Guideline / Prognostic_studies Límite: Child / Humans Idioma: En Revista: Pediatr Blood Cancer Asunto de la revista: HEMATOLOGIA / NEOPLASIAS / PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos