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

This study evaluated the variability of computer-assisted interpretation of low-dose chest CTs among radiologists in a nationwide lung cancer screening program, using a dedicated reading system (AVIEW Lungscreen, Coreline Soft). The results showed substantial inter-institution variability in interpreting screening results, attributed to different usage of the computer-assisted system. The study included 3353 baseline low-dose chest CTs, initially interpreted by 20 radiologists from 14 institutions, and then re-interpreted by a single radiologist in a retrospective central review. Positive rates by Lung-RADS varied from 7.5% to 43.3% across radiologists, while rates by the NELSON criteria varied from 11.4% to 45.0%. The central review demonstrated higher positive rates and lower inter-institution variability compared to the initial institutional reading, indicating a significant impact of individual radiologist's discretion on the interpretation of lung cancer screening results.