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
Eui Jin Hwang, Jin Mo Goo, Hyae Young Kim, Jaeyoun Yi, Soon Ho Yoon, Yeol Kim
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.