24 Chapter 2 Figure 1 Example of two cases that were scored as semi-annular by the two expert readers. There was large variation among the study readers. Case A was scored by 29% as annular, by 48% as polypoid, and by 24% as semi-annular. Case B was scored by 10% as annular, by 43% as polypoid, and by 48% as semi-annular. cT-staging Agreement with the expert reference for cT-staging was 69%, which was considerably lower than for dichotomous evaluation of low risk (cT1-2-3ab) versus high risk (cT3cd-4) cT-stage (agreement 81%). IOA was also better for the dichotomous evaluation. Results were poorest for assessment of cT4a ( 54% agreement with expert reference) and cT4b tumours (59% agreement), with understaging rates of on average 30-34% (example shown in Figure 2).
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