Agreement on computed tomographic diagnosis of mediastinal nodal stations

To investigate agreement on computed tomographic (CT) diagnosis of mediastinal nodal stations, an interpretation experiment was performed. This study consisted of 202 mediastinal nodes shown on CT images. Twenty interpreters designated each node according to the General Rules for Clinical and Pathological Record of Lung Cancer (3rd ed., The Japan Lung Cancer Society). Agreement on CT designations of mediastinal nodal stations was not satisfactory. Unclear anatomic limits of nodal stations, and the presence of mediastinal areas which meet all criteria of several nodal stations seems to cause the poor agreement on nodal stations. The addition of clear anatomic limits and giving priority to the General Rules appear to be useful for improving agreement on disignating mediastinal nodal stations. However, agreement on decision of nodal sides (right or left) was relatively good. (author)