liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Visualization of liver lesions in standardized video-documented ultrasonography - inter-observer agreement and effect of contrast injection
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences.
Show others and affiliations
2015 (English)In: Medical ultrasonography, ISSN 1844-4172, E-ISSN 2066-8643, Vol. 17, no 4, 437-443 p.Article in journal (Refereed) PublishedText
Abstract [en]

The aim of this study was to evaluate the inter-observer agreement and effect of contrast injection on the visibility of liver lesions by radiologists reviewing ultrasound examinations acquired by a radiographer using a standardized examination protocol. Material and method: A retrospective review was conducted by two radiologists, independently of each other, of 115 ultrasound examinations of the liver with standardized examination protocols between January 2008 and December 2012. All patients included in the study had undergone surgery for colorectal cancer. Patients attending the two-year follow-up were included. Results: Focal findings, the most common of which were cysts, were seen in 42-43 out of the 115 patients before intravenous contrast and in 46-47 patients after intravenous contrast (p=0.012). The inter-observer agreement for focal findings was 86.1% before contrast, and 90.4% after contrast (n.s.), and the corresponding kappa values were 0.72 and 0.84, respectively. Conclusion: A good inter-observer agreement between two radiologists reviewing ultrasound examinations (standardized ultrasound cine-loop method acquired by a radiographer) after surgery for colorectal cancer was obtained. Injection of contrast medium increased the visibility of liver lesions.

Place, publisher, year, edition, pages
Cluj-Napoca, Romania: Societatea Romana de Ultrasonografie in Medicina si Biologie , 2015. Vol. 17, no 4, 437-443 p.
Keyword [en]
liver; contrast-enhanced ultrasound; inter-observer agreement; standardized examination
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-123790DOI: 10.11152/mu.2013.2066.174.visISI: 000365549400004PubMedID: 26649336OAI: oai:DiVA.org:liu-123790DiVA: diva2:892940
Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2016-04-24Bibliographically approved
In thesis
1. Standardized ultrasonography with cine-loop documentation: diagnostic variability in liver and kidney examinations
Open this publication in new window or tab >>Standardized ultrasonography with cine-loop documentation: diagnostic variability in liver and kidney examinations
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Ultrasound examination of the abdomen is often a first choice at radiology departments due to the lack of ionizing radiation. For diagnostic accuracy and economic benefits there has been a need for new routines in this area that incorporate the benefits of an radiographer or sonographer performing a multitude of ultrasound examinations following strictly standardized examination protocols and documentation forms made by cine-loops that will give the radiologist access to all relevant information needed for an accurate postexamination diagnosis.

Aim: The overall objective of this thesis was to evaluate the diagnostic variability in examinations of the kidneys and liver that use a standardized ultrasound method along with video documentation of the entire examination and off-line review by radiologists. More specifically, we wanted to compare the agreement between readers and between operators.

Design and method: This thesis is based on four quantitative studies using standardized protocols for kidney, liver and gallbladder examinations. In paper I, including 64 patients, and paper IV, including 98 patients, the patients were prospectively enrolled and the  examinations were retrospectively reviewed. The patients in papers I and IV were examined by one radiographer (sonographer) and one radiologist during the same session. In paper I, findings using the standardized ultrasound method were compared with traditional bedside assessments by a radiologist. In paper IV, the patients were examined using only the standardized method. In paper II, including 98 patients, and in paper III, including 115 patients, the patients were examined by one sonographer using the standardized method and the examinations were reviewed by two or three radiologists.

Results: In paper I, no significant systematic differences were found between the findings using the standardized method and the traditional bedside assessment.

Paper II showed good intra- and inter-observer agreement between three experienced radiologists when reviewing examinations conducted using the standardized method.

In paper III we verified good inter-observer agreement between two radiologists reviewing ultrasound examinations using the standardized technique in patients who had undergone surgery for colorectal cancer. Intravenous contrast was used and the injection of contrast medium increased the visibility of liver lesions.

In paper IV, we observed that using a standardized cine-loop technique, there was a slightly better inter-operator agreement than inter-reader agreement.

Conclusion: The satisfactory agreement shown in all four studies suggests that the new workflow method using standardized ultrasound examinations and stored cine-loops, performed by a radiographer or sonographer and analyzed off-line by a radiologist, is a promising technique. The results are less affected when a radiologist examiner is replaced by a radiographer or sonographer than when the reviewer is replaced by a different radiologist.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 64 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1483
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-124676 (URN)10.3384/diss.diva-124676 (DOI)978-91-7685-946-9 (Print) (ISBN)
Public defence
2016-01-29, Berzeliussalen, Campus US, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2016-02-10 Created: 2016-02-09 Last updated: 2016-02-10Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Stenman, CarinaDavidsson, JoakimKnutsson, AndersSmedby, Örjan
By organisation
Department of Medical and Health SciencesFaculty of Medicine and Health SciencesDepartment of Radiology in LinköpingCenter for Medical Image Science and Visualization (CMIV)Division of Radiological Sciences
In the same journal
Medical ultrasonography
Radiology, Nuclear Medicine and Medical Imaging

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 161 hits
ReferencesLink to record
Permanent link

Direct link