Augmenting inter-rater concordance of radiologic extranodal extension in HPV-positive oropharyngeal carcinoma: A multicenter study

F. Hoebers, E. Yu, B. O'Sullivan, A.A. Postma, W.M. Palm, E. Bartlett, J. Lee, S. Stock, S. Koyfman, J. Su, W. Xu, S.H. Huang*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: To assess intra- and inter-institutional concordance and identify methods to increase precision in radiologic extranodal extension (rENE) ascertainment in HPV+ oropharyngeal carcinoma. Methods: Six radiologists, blinded to clinical outcomes, from three centers assessed rENE in two phases: Phase-I (20 cases) utilized each individual's a priori appreciation of the literature. Phase-II (30 additional cases) was performed after deliberating experience and consolidating operating definitions. Intra- and inter-institutional Kappa were calculated at >50% and >75% certainty levels, respectively. Results: The Phase-I intra-institutional kappa was 0.76, 0.32, and 0.44 at >50% certainty and improved to 0.89, 0.61, and 0.66 at >75% certainty. Inter-institutional Fleiss' kappa also improved with higher certainty (from 0.40 to 0.57, p = 0.039). The Phase-II inter-rater kappa was significantly higher than Phase-I at the same certainty level (both p < 0.001). Conclusion: A learning curve exists for rENE assessment. Strategies to augment reliability include high certainty for declaration, consolidated operating definitions, and sharing experience among radiologists.

Original languageEnglish
Pages (from-to)2361-2369
Number of pages9
JournalHead and Neck-Journal for the Sciences and Specialties of the Head and Neck
Volume44
Issue number11
Early online date29 Jun 2022
DOIs
Publication statusPublished - Nov 2022

Keywords

  • HEAD
  • OUTCOMES
  • computed tomography
  • extranodal extension
  • interobserver agreement
  • magnetic resonance imaging
  • oropharyngeal carcinoma
  • radiology
  • Extranodal extension
  • Interobserver agreement
  • Computed tomography
  • Magnetic resonance imaging
  • Radiology
  • Oropharyngeal carcinoma

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