title: Inter-observer agreement for the evaluation of bone involvement on Whole Body Low Dose Computed Tomography (WBLDCT) in Multiple Myeloma (MM).
abstract: OBJECTIVE
  We aimed to assess inter-observer agreement in bone involvement evaluation and define accuracy and reproducibility of MDCT images analysis in Multiple Myeloma (MM), by comparing two acquisition protocols at two different institutions.
  
  
  METHODS
  A total of 100 MM patients underwent whole body low-dose computed tomography (WB-LDCT), with two protocols: Group I (50 patients), 80 kV and 200-230 mAs; Group II, 120 kV-40 mAs. Four readers (two experts) retrospectively reviewed 22 anatomical districts, reporting the following for each patient: 1) osteolytic lesions; 2) cortical bone integrity; 3) fractures; 4) risk of vertebral collapse; 5) hyperattenuating bone lesions; and 6) extraosseous extension. Inter-observer agreement (by all readers, expert and young observers and comparison of the two protocols) was then statistically analyzed.
  
  
  RESULTS
  According to Cohen's criteria, inter-observer agreement among the four readers and between experts and residents was good for the detection of bone lesions and extra-medullary extension, and for the evaluation of risk of collapse and cortical integrity. There was good agreement when comparing the two protocols. A greater variability was found for the evaluation of hyperattenuating lesions and the presence of fractures.
  
  
  CONCLUSIONS
  WB-LDCT represents a reproducible and reliable technique that is helpful for defining bone disease in MM patients, with partial influence of readers' experience.
  
  
  CONCLUSIONS
  • MDCT represents a reproducible technique for defining bone disease in MM. • Overall inter-observer agreement is good, even when comparing two different protocols. • Influence of readers' experience on image analysis is partial.
authors.affiliation: Institute of Radiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy. michelazacchino@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Zacchino
authors.affiliation: Department of Diagnostic Radiology, University of Milano Bicocca, San Gerardo Hospital, Via Pergolesi 33, Monza, 20900, Italy.
authors.forename: P A
authors.initials: PA
authors.lastname: Bonaffini
authors.affiliation: Division of Hematology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Corso
authors.affiliation: Institute of Radiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Minetti
authors.affiliation: Department of Diagnostic Radiology, University of Milano Bicocca, San Gerardo Hospital, Via Pergolesi 33, Monza, 20900, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nasatti
authors.affiliation: Service of Biometry & Statistics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.affiliation: Institute of Radiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Dore
authors.affiliation: Institute of Radiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Calliada
authors.affiliation: Department of Diagnostic Radiology, University of Milano Bicocca, San Gerardo Hospital, Via Pergolesi 33, Monza, 20900, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sironi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging*; D015588:Observer Variation; D010014:Osteolysis / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging / Q000379:methods
keywords: Agreement; Bone involvement; Inter-observer; Multidetector computed tomography; Multiple myeloma