Inter-observer agreement of paranasal sinus computed tomography scans

Abstract

Conclusion: The study demonstrated considerable inter-observer variation in certain surgically important structures. This would indicate the significance for consultation when evaluating sinus CT scans of CRS patients for planned advanced sinus surgery.

Objectives: After the failure of medical treatment of chronic rhinosinusitis (CRS), the need for surgery and the pre-operative planning of safe surgery is based on computed tomography (CT) findings. The aim of this prospective study was to compare inter-observer agreement of anatomical and surgical structures of sinus CT scans. The hypothesis was that the agreement between observers is good.

Methods: Of these 57 CRS patients, Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. The reproducibility of the findings between three observers, a radiologist, an Ear, nose and throat (ENT) surgeon, and an ENT resident, were compared.

Results: In general, there was moderate inter-observer agreement of the structures by Cohen’s kappa coefficient. Poor reproducibility was observed in the following structures: optic nerve, insertion of the uncinated process, anterior ethmoidal artery, and Keros class.

Keywords:

• CT
• inter-observer
• reproducibility
• chronic rhinosinusitis
• sinus imaging

Acknowledgments

The authors thank Mikko Suvinen, MD, and Anna-Maija Kuukka, MD, for collaboration, and research nurse Marja-Leena Oksanen for her excellent assistance. The authors thank the University of Helsinki.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

The study was supported in part by research grants from the Ahokas Foundation, Competitive Research Funding of the Tampere University Hospital [Grants 9H067, 9J108, 9L087], The Finnish Medical Society Duodecim, The Finnish Society of Allergology and Immunology, Helsinki University Central Hospital Research Funds, The Ida Monti Foundation, The Jane and Aatos Erkko Foundation, The Väinö and Laina Kivi Foundation, and The Yrjö Jahnsson Foundation.