Intra- and Interobserver Variability in Magnetic Resonance Imaging Measurements in Rectal Cancer Patients

Abstract

Colorectal cancer is the second most common cancer in Europe, and accurate lymph node staging in rectal cancer patients is essential for the selection of their treatment. MRI lymph node staging is complex, and few studies have been published regarding its reproducibility. This study assesses the inter- and intraobserver variability in lymph node size, apparent diffusion coefficient (ADC) measurements, and morphological characterization among inexperienced and experienced radiologists. Four radiologists with different levels of experience in MRI rectal cancer staging analyzed 36 MRI scans of 36 patients with rectal adenocarcinoma. Inter- and intraobserver variation was calculated using interclass correlation coefficients and Cohens-kappa statistics, respectively. Inter- and intraobserver agreement for the length and width measurements was good to excellent, and for that of ADC it was fair to good. Interobserver agreement for the assessment of irregular border was moderate, heterogeneous signal was fair, round shape was fair to moderate, and extramesorectal lymph node location was moderate to almost perfect. Intraobserver agreement for the assessment of irregular border was fair to substantial, heterogeneous signal was fair to moderate, round shape was fair to moderate, and extramesorectal lymph node location was substantial to almost perfect. Our data indicate that subjective variables such as morphological characteristics are less reproducible than numerical variables, regardless of the level of experience of the observers.

Intra- and interobserver agreement of rectal cancer staging with MRI

“…Grimm et al demonstrated that the agreement was very high for lymph node length and width but relatively lower for morphologic properties. (18) They have proposed that the agreement for N staging may be relatively lower due to the high number of criteria for lymph node assessment. Also, interpretation of subcentimetric lymph nodes may lead to a low agreement, as observed in the present study and in a previous study.…”

“…As treatment options may change depending on the stage of the rectal cancer, the reliability of the staging is critical in the management of these patients. There are limited data in terms of the detailed analysis of intra-and inter-observer agreement of MRI staging of rectal cancers, including TNM subcategories (14)(15)(16)(17)(18). Most of the studies do not include the agreement for subcategories.…”

Interobserver Reliability and the Sigmoid Takeoff—An Interobserver Study

“…The observers measured the anal verge and anorectal junction using MRI T2-weighted images in the sagittal scan plan. The MRI protocol can be seen in more detail in [ 9 , 10 ].…”

Lightweight preprocessing and template matching facilitate streamlined ischemic myocardial scar classification

“…In addition, there can be interobserver variability, with varying standards between different clinicians potentially leading to different classifications. While workload management, experience, and training can help mitigate these factors, 21 – 23 the existence of these challenges is well-documented and a continued topic of research.…”