Accuracy and interobserver variation in the interpretation of computed tomography in solitary brain lesions
J. J. Heimans, M. De Visser, C. H. Polman, J. Nauta, W. Kamphorst and D. Troost
Department of Neurology, Free University Hospital, Amsterdam, The Netherlands.
The clinical data and computed tomographic findings of 64 patients with
solitary supratentorial brain lesions were presented to two panels of six
experienced clinicians. The diagnoses predicted by these clinicians were
compared with each other (interobserver variation) and with the definite
diagnosis, which in almost all cases was based on histologic examination of
the involved tissue (validity of predicted diagnosis). The interobserver
agreement was only moderate. The predicted diagnoses agreed with the
definite diagnoses in only 57% of cases. A high number of errors were made
in distinguishing between high-grade and low-grade glioma and between
high-grade glioma and cerebral metastasis, and in the detection of primary
cerebral lymphoma. Possible implications of these findings for clinical
practice are discussed.
