ArticleEuropean radiology2021
Variability in interpretation of low-dose chest CT using computerized assessment in a nationwide lung cancer screening program: comparison of prospective reading at individual institutions and retrospective central reading.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Software with artificial intelligence-derived algorithms for detecting and analysing lung nodules in CT scans: systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2025Pooled it
- Pooled it
- Variability Among Radiologists in Interpreting Low-Dose CT Lung Cancer Screens.Journal of the American College of Radiology : JACR · 2026Article
- Post-Tuberculosis Sequelae and Active Tuberculosis in Lung Cancer: Imaging Patterns and Clinical Associations-A Retrospective Single-Center Cohort Study.Journal of clinical medicine · 2026Article
- Nodule Characteristics, Clinical Risk Factors, and Radiologist Experience as Predictors of Positive Baseline LDCT Screening Results.Healthcare (Basel, Switzerland) · 2025Article
- Comparison of surveillance modalities in the surveillance of sinonasal squamous cell carcinoma recurrence: A multi-institutional study.International forum of allergy & rhinology · 2025Article
- Comparison of AI software tools for automated detection, quantification and categorization of pulmonary nodules in the HANSE LCS trial.Scientific reports · 2024Article
- See Lung Cancer with an AI.Cancers · 2023Review
- Single CT Appointment for Double Lung and Colorectal Cancer Screening: Is the Time Ripe?Diagnostics (Basel, Switzerland) · 2022Review
- Low-dose CT for lung cancer screening: position paper from the Italian college of thoracic radiology.La Radiologia medica · 2022Article
- Community-based Lung Cancer Screening Results in Relation to Patient and Radiologist Characteristics: The PROSPR Consortium.Annals of the American Thoracic Society · 2022Article
- Determination of the optimum definition of growth evaluation for indeterminate pulmonary nodules detected in lung cancer screening.PloS one · 2022Article
- Effectiveness of radiologist training in improving reader agreement for Lung-RADS 4X categorization.European radiology · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 4 countries.
Funding
Abstract
objectivesTo evaluate the degree of variability in computer-assisted interpretation of low-dose chest CTs (LDCTs) among radiologists in a nationwide lung cancer screening (LCS) program, through comparison with a retrospective interpretation from a central laboratory. MATERIALS AND
methodsConsecutive baseline LDCTs (n = 3353) from a nationwide LCS program were investigated. In the institutional reading, 20 radiologists in 14 institutions interpreted LDCTs using computer-aided detection and semi-automated segmentation systems for lung nodules. In the retrospective central review, a single radiologist re-interpreted all LDCTs using the same system, recording any non-calcified nodules ≥ 3 mm without arbitrary rejection of semi-automated segmentation to minimize the intervention of radiologist's discretion. Positive results (requiring additional follow-up LDCTs or diagnostic procedures) were initially classified by the lung CT screening reporting and data system (Lung-RADS) during the interpretation, while the classifications based on the volumetric criteria from the Dutch-Belgian lung cancer screening trial (NELSON) were retrospectively applied. Variabilities in positive rates were assessed with coefficients of variation (CVs).
resultsIn the institutional reading, positive rates by the Lung-RADS ranged from 7.5 to 43.3%, and those by the NELSON ranged from 11.4 to 45.0% across radiologists. The central review exhibited higher positive rates by Lung-RADS (20.0% vs. 27.3%; p < .001) and the NELSON (23.1% vs. 37.0%; p < .001), and lower inter-institution variability (CV, 0.30 vs. 0.12, p = .003 by Lung-RADS; CV, 0.25 vs. 0.12, p = .014 by the NELSON) compared to the institutional reading.
conclusionConsiderable inter-institution variability in the interpretation of LCS results is caused by different usage of the computer-assisted system. KEY POINTS: • Considerable variability existed in the interpretation of screening LDCT among radiologists partly from the different usage of the computerized system. • A retrospective reading of low-dose chest CTs in the central laboratory resulted in reduced variability but an increased positive rate.
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