Interobserver variability in chest CT and whole body FDG-PET screening for distant metastases in head and neck cancer patients.
OBJECTIVE
The aim of the study was to assess the interobserver variability in chest computed tomography (CT) and whole body 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography (FDG-PET) screening for distant metastases in head and neck squamous cell carcinoma (HNSCC) patients.


METHODS
Chest CT and whole body FDG-PET of 69 HNSCC patients with high-risk factors who underwent screening for distant metastases were analyzed. All scans were independently read by two experienced radiologists or nuclear physicians who were blinded to the other examinations and follow-up results.


RESULTS
A kappa of 0.516 was found for assessment of size on CT. Kappa values for origin and susceptibility of 0.406 and 0.512 for CT and 0.834 and 0.939 for PET were found, respectively. The overall conclusions had a kappa of 0.517-0.634 for CT and 0.820-1.000 for PET.


CONCLUSIONS
In screening for distant metastases in HNSCC patients with high-risk factors, chest CT readings had a reasonable to substantial agreement, while PET readings showed an almost perfect agreement. These findings suggest that for optimal assessment in clinical practice, PET most often can be scored by one observer, but CT should probably more often be scored by different observers in consensus or combined with PET.
Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Asaf
A
Senft
Remco
R
de Bree
Richard P
RP
Golding
Emile F I
EF
Comans
Jan-Hein T M
JH
Van Waesberghe
J Dirk
JD
Kuik
Otto S
OS
Hoekstra
C René
CR
Leemans
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging*; D015588:Observer Variation; D049268:Positron-Emission Tomography; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
D019788:Fluorodeoxyglucose F18