Image analysis in posttreatment non-small cell lung cancer surveillance: specialists’ interpretations reviewed by the thoracic multidisciplinary tumor board

  • Franco Gambazzi Clinic of Thoracic Surgery, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Lukas D. Frey Institute of Nuclear Medicine and PET-Center, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Matthias Bruehlmeier Institute of Nuclear Medicine and PET-Center, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Wolf-Dieter Janthur Clinic of Oncology, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Juerg Heuberger Clinic of Radio-Oncology, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Andres Spirig Department of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Richard Williams Department of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Roland Zweifel Institute of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Bettina Boerner Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Tellstrasse, Aarau, Switzerland.
  • Gabrielo M. Tini Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Tellstrasse, Aarau, Switzerland.
  • Sarosh Irani | siran@gmx.ch Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Aarau, Switzerland. http://orcid.org/0000-0001-6471-1512

Abstract

Background: Data show that the initial specialist’s image interpretation and final multidisciplinary tumor board (MTB) assessment can vary substantially in the pretherapeutic cancer setting. The aim of this post hoc analysis was to investigate the concordance of the specialist’s and MTB’s image interpretations in patients undergoing systematic posttreatment lung cancer image surveillance.

Methods: In the initial prospective study, lung cancer patients who had received curative-intent treatment were randomly assigned to undergo either contrast-enhanced computed tomography (CE-CT) or integrated 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). Imaging was performed every 6months for 2 years, and all imaging studies were finally assessed by our MTB. This post hoc analysis assessed differences between the initial specialist’s image interpretation and the final MTB’s image interpretation.

Results: In 89 patients, 266 imaging studies (129 PET-CT, 137 CE-CT) were analyzed. In 87.2% (88.4, 86.1%) of the studies, complete concordance was found. Out of the 12.8% (11.6, 13.9%) with discordant results, 7.5% (6.9, 8.0%) had implications for alterations in patient management (major disagreements). Twenty major disagreements were detected in 17 study patients. Retrospectively, in eight out of these 17 (47%) patients, in contrast to the MTB’s view, the specialist’s interpretation was more appropriate, whereas in nine out of 17 patients (53%), the MTB’s interpretation was more accurate.

Conclusions: In an experienced MTB, the agreement between imaging specialists and the rest of the MTB with regard to the interpretation of images is high in a setting of posttreatment lung cancer image surveillance. It seems that in cases of disagreements, the rates of more accurate interpretation are well balanced between imaging specialists and the MTB.

Trial registration: ISRCTN16281786, Date 23. February 2017.

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Published
2019-12-04
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Original Research Articles
Keywords:
Posttreatment lung cancer surveillance, Agreement on imaging, Multidisciplinary tumor board
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How to Cite
Gambazzi, F., Frey, L. D., Bruehlmeier, M., Janthur, W.-D., Heuberger, J., Spirig, A., Williams, R., Zweifel, R., Boerner, B., Tini, G. M., & Irani, S. (2019). Image analysis in posttreatment non-small cell lung cancer surveillance: specialists’ interpretations reviewed by the thoracic multidisciplinary tumor board. Multidisciplinary Respiratory Medicine, 14(1). https://doi.org/10.4081/mrm.2019.485