Reliability of interpretation of CT examination of the larynx in patients with glottic laryngeal carcinoma.
BACKGROUND
Reports in literature suggest that tumor volume, cartilage invasion, and cartilage sclerosis are independent prognostic factors for tumor control in radiotherapy as primary treatment of laryngeal carcinomas.


OBJECTIVE
Assessment of the interobserver variability and prognostic value in the measurement of tumor volume, cartilage invasion, and sclerosis.


METHODS
Retrospective analysis of 55 CT scans by three independent observers. Volume measurements and determination of cartilage invasion, cartilage sclerosis, and tumor localization were calculated. Correlation between the prognostic factors and radiotherapy was calculated for each observer.


RESULTS
Values for interobserver agreement varied substantially; cartilage invasion (kappa value: -0.02 to 0.66), cartilage sclerosis (kappa value: 0.13 to 0.57), tumor localization of subsites (kappa value: 0.03 to 0.60), and tumor volume (correlation: 0.34 to 0.73). The found interobserver variation makes it impossible to establish accurate prognostic factors.


CONCLUSIONS
Determination of tumor volume, cartilage invasion, and cartilage sclerosis on the basis of CT imaging shows considerable interobserver variation; clinical significance appears to be limited.


METHODS
B-3a.
Hoorweg
J J
JJ
Department of Otorhinolaryngology and Head and Neck Surgery, Flevoziekenhuis Almere, Hospitaalweg 1, 1315 Almere, the Netherlands. jhoorweg@flevoziekenhuis.nl
Kruijt
R H
RH
Heijboer
R J J
RJ
Eijkemans
M J C
MJ
Kerrebijn
J D F
JD
D002277:Carcinoma / Q000000981:diagnostic imaging*; D005931:Glottis / Q000000981:diagnostic imaging*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging*; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D015588:Observer Variation; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*