Interobserver agreement between interpretations of acute changes after lung stereotactic body radiotherapy
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ORIGINAL ARTICLE
Interobserver agreement between interpretations of acute changes after lung stereotactic body radiotherapy Meltem Dağdelen1
· Emine Sedef Akovalı1 · Ceren Barlas1 · Günay Can2 · Fazilet Öner Dinçbaş1
Received: 16 April 2020 / Accepted: 2 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Stereotactic body radiation therapy (SBRT) is an effective treatment modality for inoperable early-stage lung cancer or metastatic lung lesions. Post-SBRT, acute radiological lung changes sometimes mimic tumor progression, so over-investigation may be applied. We aimed to reveal the interobserver agreement among physicians regarding acute radiographic changes on CT of the thorax obtained shortly after SBRT Materials and methods Radiologic images of 20 lesions treated with SBRT were evaluated for acute lung changes. Two physicians, one senior and one junior, from diagnostic radiology, radiation oncology, nuclear medicine, and chest disease departments reviewed these images. The final interpretations were categorized as stable, regression/consolidation, progressive disease, and SBRT-related changes. The evaluations of the physicians were compared with the experienced reference radiation oncologist. The gold standard was accepted as the reference physician’s final score. Unweighted Cohen’s kappa (κ) coefficient was used for assessing interobserver agreement between physicians. Results The evaluations of the physicians were compared with the reference radiation oncologist. The strongest coherence coefficient was found with the senior radiation oncologist (κ: 0.72). The kappa coefficients between the junior radiation oncologist, junior nuclear medicine physician, and the reference physician were 0.61 and 0.55, respectively. The disciplines with the lowest kappa coefficients were junior chest disease and senior radiologist, and the kappa values were 0.37 and 0.44, respectively. Conclusion Disciplines dealing with lung cancer treatment may not be aware of the various radiologic changes after SBRT or inexperienced in interpreting them from recurrence. Therefore, physicians must have detailed radiotherapy information such as planning target volume (PTV), dose/fractionation, etc. In addition, final evaluations should be performed in the multidisciplinary team dealing with the treatment of the patient
Keywords SBRT · Interdisciplinary agrement · Acute lung changes after SBRT · Evaluation of lung changes
Introduction Stereotactic body radiation therapy (SBRT) is a treatment modality that allows delivery of a high radiation dose to the target volume, at the same time minimizing the dose to organs at risk. SBRT has been demonstrated to be effective in the treatment of inoperable stage I lung cancer or lung
Dr. Meltem Da˘gdelen, MD
[email protected] 1
Department of Radiation Oncology, Cerrahpa¸sa Medical Faculty, Istanbul University—Cerrahpa¸sa, Cerrahpa¸sa Ave. Kocamustafapa¸sa St. No:34/E Fatih, Istanbul, Turkey
2
Department of Public Health, Cerrahpa¸sa Medical
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