Reliability of X-rays and bone scans for the assessment of changes in skeletal metastases from breast cancer
- Author(s)
- Shackleton, M; Yuen, K; Little, AF; Schlicht, S; McLachlan, SA;
- Details
- Publication Year 2004-11,Volume 34,Issue #11,Page 615-620
- Journal Title
- INTERNAL MEDICINE JOURNAL
- Publication Type
- Journal Article
- Abstract
- Aims : To examine the level of agreement among observers regarding changes between serial images of bone metastases. Methods : Thirty-five pairs of bone X-rays and 30 pairs of bone scans were selected from the files of patients with breast cancer involving the skeleton. All images in a pair were of the same site and had been taken at least 12 weeks apart. Thirteen radiologists and 14 nuclear medicine physicians examined the X-ray and bone scan pairs, respectively. Each assessed whether the changes between sequential films represented improvement, stability or worsening. Inter-observer agreement was analysed using the kappa statistic (kappa). Results : There was only fair overall agreement among radiologists regarding changes between X-rays (kappa = 0.23), but there was substantial agreement among nuclear medicine physicians for bone scan assessments (kappa = 0.62). Neither the experience of the observers nor the time between images had a significant effect on agreement. For X-rays, agreement was poorer if the response category was 'improvement' and if the type of bone lesion was mixed lytic/sclerotic. Conclusions : Evaluation of serial X-rays is unreliable for determining the response of bone metastases. Scintigraphic evaluation has a higher internal validity for the determination of response, but it should not be used in isolation from other clinical data.
- Publisher
- BLACKWELL PUBLISHING ASIA
- Keywords
- SYSTEMIC TREATMENT; ASSESSING RESPONSE; THERAPY; ONCOLOGY; CHEMOTHERAPY; TRIALS
- Publisher's Version
- https://doi.org/10.1111/j.1445-5994.2004.00637.x
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2004-11-01 12:00:00