{
    "abstract": "Radiation-associated lymphedema and fibrosis (LEF) is a significant toxicity following radiation therapy (RT) for head and neck cancer (HNC) patients. Recently, the CT Lymphedema and Fibrosis Assessment Tool (CT-LEFAT) was developed to standardize LEF diagnosis through fat stranding visualized on CT. This study aims to evaluate the inter-observer reliability and diagnostic accuracy of the CT-LEFAT criteria.\nThis study retrospectively evaluated 26 HNC patients treated with RT that received a minimum of two contrast-enhanced CT scans. Qualitative review was conducted by five physician raters to assess the fat stranding observed on CT according to the CT-LEFAT criteria. Fleiss' kappa analysis was used to assess the inter- and intra-rater reliability, and Receiver Operating Characteristic (ROC) Area Under the Curve (AUC) analysis was used to evaluate diagnostic accuracy.\nThe inter-rater reliability across the six CT-LEFAT regions generally indicated a slight to fair agreement across all raters (0.04 \u2264 kappa \u2264 0.36). Intra-observer agreement was generally fair to moderate (overall kappa=0.44). The ROC AUC analysis varied based on aggregation method used (0.60 \u2264 average AUC \u2264 0.70).\nThis specific use-case evaluating CT-LEFAT criteria displays limited performance. This suggests that additional materials, such as further training, refinement of imaging methods, or other processes may be required before achieving clinically-ready diagnostic performance of LEF diagnosis.",
    "authors": [
        {
            "affiliation": null,
            "firstname": null,
            "initials": null,
            "lastname": null
        }
    ],
    "conclusions": "This specific use-case evaluating CT-LEFAT criteria displays limited performance. This suggests that additional materials, such as further training, refinement of imaging methods, or other processes may be required before achieving clinically-ready diagnostic performance of LEF diagnosis.",
    "copyrights": null,
    "doi": "10.1101/2024.09.17.24313809\n10.1089/lrb.2016.0001\n10.1089/lrb.2017.0024\n10.1016/j.jpainsymman.2011.03.019\n10.1007/s00405-023-07841-0\n10.1188/13.ONF.501-506\n10.1097/MOO.0b013e32833aac21\n10.1016/j.ejon.2014.07.006\n10.1016/j.jclinepi.2010.03.002\n10.2214/AJR.10.4375\n10.1089/lrb.2021.0100\n10.1016/j.jbi.2019.103208",
    "journal": "medRxiv : the preprint server for health sciences",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-10-07",
    "pubmed_id": "39371132\n27305456\n29432066\n21802897\n36763153\n23989023\n20463478\n17847721\n25190635\n21130355\n26359872\n21700969\n2492719\n24293042\n35679595\n18929686\n31078660\n843571",
    "results": "The inter-rater reliability across the six CT-LEFAT regions generally indicated a slight to fair agreement across all raters (0.04 \u2264 kappa \u2264 0.36). Intra-observer agreement was generally fair to moderate (overall kappa=0.44). The ROC AUC analysis varied based on aggregation method used (0.60 \u2264 average AUC \u2264 0.70).",
    "title": "Evaluating Observer Reliability and Diagnostic Accuracy of CT-LEFAT Criteria for Post-Treatment Head and Neck Lymphedema: A Prospective Blinded Comparative Analysis of Oncologist Human Inter-Rater Performance.",
    "xml": "<Element 'PubmedArticle' at 0x7885043625c0>"
}