Reliability of X-rays and bone scans for the assessment of changes in skeletal metastases from breast cancer

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 (κ). Results: There was only fair overall agreement among rad..