Inter-Observer Agreement of Whole-Body Computed Tomography in Staging and Response Assessment in Lymphoma: The Lugano Classification.

Background: To assess inter-observer agreement of whole-body computed tomography (WBCT) in staging and response assessment in lymphoma according to the Lugano classification.

Material/methods: Retrospective analysis was conducted of 115 consecutive patients with lymphomas (45 females, 70 males; mean age of 46 years). Patients underwent WBCT with a 64 multi-detector CT device for staging and response assessment after a complete course of chemotherapy. Image analysis was performed by 2 reviewers according to the Lugano classification for staging and response assessment.

Results: The overall inter-observer agreement of WBCT in staging of lymphoma was excellent (=0.90, percent agreement=94.9%). There was an excellent inter-observer agreement for stage I (=0.93, percent agreement=96.4%), stage II (=0.90, percent agreement=94.8%), stage III (=0.89, percent agreement=94.6%) and stage IV (=0.88, percent agreement=94%). The overall inter-observer agreement in response assessment after a completer course of treatment was excellent (=0.91, percent agreement=95.8%). There was an excellent inter-observer agreement in progressive disease (=0.94, percent agreement=97.1%), stable disease (=0.90, percent agreement=95%), partial response (=0.96, percent agreement=98.1%) and complete response (=0.87, Percent agreement=93.3%).

Conclusions: We concluded that WBCT is a reliable and reproducible imaging modality for staging and treatment assessment in lymphoma according to the Lugano classification.