Inter-observer agreement for the evaluation of bone involvement on Whole Body Low Dose Computed Tomography (WBLDCT) in Multiple Myeloma (MM)

M. Zacchino, P. A. Bonaffini, A. Corso, V. Minetti, A. Nasatti, C. Tinelli, R. Dore, F. Calliada, S. Sironi

Research output: Contribution to journalArticlepeer-review


Objective: We aimed to assess inter-observer agreement in bone involvement evaluation and define accuracy and reproducibility of MDCT images analysis in Multiple Myeloma (MM), by comparing two acquisition protocols at two different institutions. Methods: A total of 100 MM patients underwent whole body low-dose computed tomography (WB-LDCT), with two protocols: Group I (50 patients), 80 kV and 200-230 mAs; Group II, 120 kV-40 mAs. Four readers (two experts) retrospectively reviewed 22 anatomical districts, reporting the following for each patient: 1) osteolytic lesions; 2) cortical bone integrity; 3) fractures; 4) risk of vertebral collapse; 5) hyperattenuating bone lesions; and 6) extraosseous extension. Inter-observer agreement (by all readers, expert and young observers and comparison of the two protocols) was then statistically analyzed. Results: According to Cohen’s criteria, inter-observer agreement among the four readers and between experts and residents was good for the detection of bone lesions and extra-medullary extension, and for the evaluation of risk of collapse and cortical integrity. There was good agreement when comparing the two protocols. A greater variability was found for the evaluation of hyperattenuating lesions and the presence of fractures. Conclusions: WB-LDCT represents a reproducible and reliable technique that is helpful for defining bone disease in MM patients, with partial influence of readers’ experience. Key Points: • MDCT represents a reproducible technique for defining bone disease in MM. • Overall inter-observer agreement is good, even when comparing two different protocols. • Influence of readers’ experience on image analysis is partial.

Original languageEnglish
Pages (from-to)3382-3389
Number of pages8
JournalEuropean Radiology
Issue number11
Publication statusPublished - Nov 1 2015


  • Agreement
  • Bone involvement
  • Inter-observer
  • Multidetector computed tomography
  • Multiple myeloma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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