OBJECTIVE: The purpose of this study was to assess the impact of the observer level of experience on the diagnostic performance of contrast-enhanced ultrasound imaging (CEUS) for differentiation between benign and malignant liver tumors. METHODS: From a computerized search, we retrospectively identified 286 biopsy-proven liver tumors (105 hepatocellular carcinomas, 48 metastases, 7 intra-hepatic cholangiocarcinomas, 33 liver hemangiomas, and 93 nonhemangiomatous benign lesions) in 235 patients (140 male and 95 female; mean age +/- SD, 56 +/- 11 years) who underwent CEUS after sulfur hexafluoride-filled microbubble injection. The digital cine clips recorded during the arterial (10-35 seconds from injection), portal (50-120 seconds), and late (130-300 seconds) phases were analyzed by 6 independent observers without experience (group 1, observers 1-3) or with 2 to 10 years of experience in CEUS (group 2, observers 4-6). Specific training in the diagnostic and interpretative criteria was provided to the inexperienced observers. Each observer used a 5-point scale to grade diagnostic confidence: 1, definitely benign; 2, probably benign; 3, indeterminate; 4, probably malignant; or 5, definitely malignant on the basis of the enhancement pattern during the arterial phase and enhancement degree during the portal and late phases compared with the liver (hypoenhancement indicating malignant and isoenhancement to hyperenhancement indicating benign). RESULTS: The analysis of observer diagnostic confidence revealed higher intragroup (kappa = 0.63-0.83) than intergroup (kappa = 0.47-0.63) observer agreement. The experienced observers showed higher diagnostic performance in malignancy diagnosis than did inexperienced observers (overall accuracy: group 1, 63.3%-72.8%; group 2, 75.9%-93.1%; P < .05, chi(2) test). CONCLUSIONS: The diagnostic performance of CEUS in liver tumor characterization was dependant on the observer's level of experience.
OBJECTIVE: The purpose of this study was to assess the impact of the observer level of experience on the diagnostic performance of contrast-enhanced ultrasound imaging (CEUS) for differentiation between benign and malignant liver tumors. METHODS: From a computerized search, we retrospectively identified 286 biopsy-proven liver tumors (105 hepatocellular carcinomas, 48 metastases, 7 intra-hepatic cholangiocarcinomas, 33 liver hemangiomas, and 93 nonhemangiomatous benign lesions) in 235 patients (140 male and 95 female; mean age +/- SD, 56 +/- 11 years) who underwent CEUS after sulfur hexafluoride-filled microbubble injection. The digital cine clips recorded during the arterial (10-35 seconds from injection), portal (50-120 seconds), and late (130-300 seconds) phases were analyzed by 6 independent observers without experience (group 1, observers 1-3) or with 2 to 10 years of experience in CEUS (group 2, observers 4-6). Specific training in the diagnostic and interpretative criteria was provided to the inexperienced observers. Each observer used a 5-point scale to grade diagnostic confidence: 1, definitely benign; 2, probably benign; 3, indeterminate; 4, probably malignant; or 5, definitely malignant on the basis of the enhancement pattern during the arterial phase and enhancement degree during the portal and late phases compared with the liver (hypoenhancement indicating malignant and isoenhancement to hyperenhancement indicating benign). RESULTS: The analysis of observer diagnostic confidence revealed higher intragroup (kappa = 0.63-0.83) than intergroup (kappa = 0.47-0.63) observer agreement. The experienced observers showed higher diagnostic performance in malignancy diagnosis than did inexperienced observers (overall accuracy: group 1, 63.3%-72.8%; group 2, 75.9%-93.1%; P < .05, chi(2) test). CONCLUSIONS: The diagnostic performance of CEUS in liver tumor characterization was dependant on the observer's level of experience.
Authors: Barbara Schellhaas; Matthias Hammon; Deike Strobel; Lukas Pfeifer; Christian Kielisch; Ruediger S Goertz; Alexander Cavallaro; Rolf Janka; Markus F Neurath; Michael Uder; Hannes Seuss Journal: Eur Radiol Date: 2018-04-19 Impact factor: 5.315
Authors: Christoph F Dietrich; Malay Sharma; Robert N Gibson; Dagmar Schreiber-Dietrich; Christian Jenssen Journal: World J Gastroenterol Date: 2013-06-07 Impact factor: 5.742
Authors: Christoph F Dietrich; Michalakis Averkiou; Michael Bachmann Nielsen; Richard G Barr; Peter N Burns; Fabrizio Calliada; Vito Cantisani; Byung Choi; Maria C Chammas; Dirk-André Clevert; Michel Claudon; Jean-Michel Correas; Xin-Wu Cui; David Cosgrove; Mirko D'Onofrio; Yi Dong; JohnR Eisenbrey; Teresa Fontanilla; Odd Helge Gilja; Andre Ignee; Christian Jenssen; Yuko Kono; Masatoshi Kudo; Nathalie Lassau; Andrej Lyshchik; Maria Franca Meloni; Fuminori Moriyasu; Christian Nolsøe; Fabio Piscaglia; Maija Radzina; Adrian Saftoiu; Paul S Sidhu; Ioan Sporea; Dagmar Schreiber-Dietrich; Claude B Sirlin; Maria Stanczak; Hans-Peter Weskott; Stephanie R Wilson; Juergen Karl Willmann; Tae Kyoung Kim; Hyun-Jung Jang; Alexandar Vezeridis; Sue Westerway Journal: Ultrasound Int Open Date: 2018-02-07
Authors: Francesco Prada; Luca Mattei; Massimiliano Del Bene; Luca Aiani; Marco Saini; Cecilia Casali; Assunta Filippini; Federico Giuseppe Legnani; Alessandro Perin; Andrea Saladino; Ignazio Gaspare Vetrano; Luigi Solbiati; Alberto Martegani; Francesco DiMeco Journal: Biomed Res Int Date: 2014-06-12 Impact factor: 3.411