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Background  This study was conducted to assess intra‐observer and inter‐observer agreements for the measurement of dual‐input whole tumor computed tomography perfusion ( DCTP ) in patients with lung cancer.    Methods  A total of 88 patients who had undergone  DCTP,  which had proved a diagnosis of primary lung cancer, were divided into two groups: (i) nodules (diameter ≤3 cm) and masses (diameter >3 cm) by size, and (ii) tumors with and without air density. Pulmonary flow, bronchial flow, and pulmonary index were measured in each group. Intra‐observer and inter‐observer agreements for measurement were assessed using intraclass correlation coefficient, within‐subject coefficient of variation, and  B land– A ltman analysis.    Results  In all lung cancers, the reproducibility coefficient for intra‐observer agreement (range 26.1–38.3%) was superior to inter‐observer agreement (range 38.1–81.2%). Further analysis revealed lower agreements for nodules compared to masses. Additionally, inner‐air density reduced both agreements for lung cancer.    Conclusion  The intra‐observer agreement for measuring lung cancer  DCTP  was satisfied, while the inter‐observer agreement was limited. The effects of tumoral size and inner‐air density to agreements, especially between two observers, should be emphasized. In future, an automatic computer‐aided segment of perfusion value of the tumor should be developed.

thoracic cancer

Intra‐observer and inter‐observer agreements for the measurement of dual‐input whole tumor computed tomography perfusion in patients with lung cancer:  I nfluences of the size and inner‐air density of tumors