Interobserver agreement for detection of malignant features of intraductal papillary mucinous neoplasms of the pancreas on MDCT Journal Article


Authors: Do, R. K. G.; Katz, S. S.; Gollub, M. J.; Li, J.; LaFemina, J.; Zabor, E. C.; Moskowitz, C. S.; Klimstra, D. S.; Allen, P. J.
Article Title: Interobserver agreement for detection of malignant features of intraductal papillary mucinous neoplasms of the pancreas on MDCT
Abstract: OBJECTIVE. The purpose of this retrospective study was to measure interobserver agreement in the assessment of malignant imaging features of intraductal papillary mucinous neoplasms (IPMNs) on MDCT. MATERIALS AND METHODS. Pancreatic protocol CT studies were reviewed for 84 patients with resected IPMNs. Maximal diameter of the dominant cyst, presence of a mural nodule, presence of a solid component, and diameters of the main pancreatic duct (MPD) and common bile duct (CBD) were measured by four radiologists independently. In each patient, the IPMN was classified into one of three types: main duct, branch duct, or mixed IPMN. Interobserver agreement of lesion features was examined using the intraclass correlation coefficient (ICC) for continuous features and Fleiss kappa for categorical features. RESULTS. The final dataset included 55 branch duct IPMNs, nine main duct IPMNs, and 20 mixed IPMNs. Moderate agreement (κ = 0.458; 95% CI, 0.345-0.564) was observed in assigning branch duct, main duct, or mixed IPMN subtypes. Measurement agreement was substantial to excellent for dominant cyst (ICC = 0.852; 95% CI, 0.777-0.907), MPD (0.753, 0.655-0.837), and CBD (0.608, 0.463-0.724) but only fair to moderate for the detection of the presence of mural nodule (κ = 0.284, 0.125-0.432) or solid component (κ = 0.405, 0211-0.577). CONCLUSION. Substantial to excellent interobserver agreement in the measurement of cyst diameter, MPD, and CBD support their use for characterizing malignant features of IPMN on MDCT. However, the subjective interpretation of the presence of solid components and mural nodules by individual radiologists was more variable. © American Roentgen Ray Society.
Keywords: adult; controlled study; human tissue; aged; major clinical study; histopathology; cancer localization; solid tumor; image analysis; observer variation; tumor volume; intraductal papillary mucinous tumor; retrospective study; correlation coefficient; radiologist; pancreas duct; invasive carcinoma; pancreatic cancer; cancer classification; observational study; radiodiagnosis; image display; multidetector computed tomography; tumor invasion; mdct; interobserver agreement; human; male; female; priority journal; article; intraductal papillary mucinous neoplasm (ipmn)
Journal Title: American Journal of Roentgenology
Volume: 203
Issue: 5
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2014-11-01
Start Page: 973
End Page: 979
Language: English
DOI: 10.2214/ajr.13.11490
PROVIDER: scopus
PMCID: PMC4337895
PUBMED: 25341134
DOI/URL:
Notes: Export Date: 3 August 2015 -- Source: Scopus
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MSK Authors
  1. Marc J Gollub
    111 Gollub
  2. Seth Stephen Katz
    16 Katz
  3. Chaya S. Moskowitz
    174 Moskowitz
  4. David S Klimstra
    858 Klimstra
  5. Peter Allen
    445 Allen
  6. Emily Craig Zabor
    136 Zabor
  7. Kinh Gian Do
    118 Do
  8. Jian Li
    1 Li