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Operator-Dependent Reproducibility of Size Measurements of Small Phantoms and Lung Nodules Examined With Low-Dose Thin-Section Computed Tomography

Objective:We sought to assess the reproducibility of size measurements of small lung nodules examined with low-dose thin-section computed tomography (LDTSCT). Materials and Methods:Three radiologists measured volume with a semiautomatic tool and diameters manually of 20 (equivalent diameter range, 5.3–11 mm) phantom nodules and 37 (mean diameter range, 5–8.5 mm) lung nodules in subjects undergoing LDTSCT. Results:In phantoms, the worst 95% limits of agreement (95% LA) for volume were −3.0% and 3.0% within operator and −3.1% and 2.8% between operators. The coefficient of repeatability (CR) for diameter ranged between 0.51 and 0.67 mm within operator and the 95% LA were from −0.71 to 0.71 mm between operators. In nodules, the worst intraoperator 95% LA for volume were −14.4% and 17.6% within operator and −13.1% and 14.2% between operators. The CR for diameter ranged between 0.48 and 0.73 mm within operator and the 95% LA were from −1.16 to 1.16 mm between operators. Conclusion:Operator-dependent variability of size measurements of small nodules examined with LDTSCT is not negligible and should be considered in lung cancer-screening studies.