Emma Calabrese1, Torsten Kucharzik2, Christian Maaser3, Giovanni Maconi4, Deike Strobel5, Stephanie R Wilson6,7, Francesca Zorzi1, Kerri L Novak7, David H Bruining8, Marietta Iacucci9, Mamoru Watanabe10, Elisabetta Lolli1, Carlo Chiaramonte1, Stephen B Hanauer10, Remo Panaccione7, Francesco Pallone1, Subrata Ghosh9, Giovanni Monteleone1. 1. Gastroenterology Unit, Department of Systems Medicine, University of Rome "Tor Vergata," Italy. 2. Department of Internal Medicine and Gastroenterology, Staedtisches Klinikum Lueneburg, Lueneburg, Germany. 3. Ambulanzzentrum Gastroenterologie am Klinikum Lüneburg, Lüneburg, Germany. 4. Department of Clinical Sciences, L. Sacco University Hospital, Milan, Italy. 5. University Hospital Erlangen, Erlangen, Germany. 6. Department of Radiology and **Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada. 7. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. 8. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan. 9. Institute of Translational of Medicine, University of Birmingham, Birmingham, UK. 10. Northwestern University Feinberg School of Medicine, Digestive Disease Center, Chicago, Illinois, USA.
Abstract
BACKGROUND: The unavailability of standardized parameters in bowel ultrasonography (US) commonly used in Crohn's disease (CD) and the shortage of skilled ultrasonographers are 2 limiting factors in the use of this imaging modality around the world. The aim of this study is to evaluate interobserver agreement among experienced sonographers in the evaluation of bowel US parameters in order to improve standardization in imaging reporting and interpretation. METHODS: Fifteen patients with an established diagnosis of CD underwent blinded bowel US performed by 6 experienced sonographers. Prior to the evaluation, the sonographers and clinical and radiological IBD experts met to formally define the US parameters. Interobserver agreement was tested with the Quatto method (s). RESULTS: All operators agreed on the presence/absence of CD lesions and distinguished absence of/mild activity or moderate/severe lesions in all patients. S values were moderate for bowel wall thickness (s = 0.48, P = n.s.), bowel wall pattern (s = 0.41, P = n.s.), vascularization (s = 0.52, P = n.s.), and presence of lymphnodes (s = 0.61, P = n.s.). Agreement was substantial for lesion location (s = 0.68, P = n.s.), fistula (s = 0.74, P = n.s.), phlegmon (s = 0.78, P = 0.04), and was almost perfect for abscess (s = 0.95, P = 0.02). Poor agreement was observed for mesenteric adipose tissue alteration, lesion extent, stenosis, and prestenotic dilation. CONCLUSIONS: In this study, the majority of the US parameters used in CD showed moderate/substantial agreement. The development of shared US imaging interpretation patterns among sonographers will lead to improved comparability of US results among centers and facilitate the development of multicenter studies and the spread of bowel US training, thereby allowing a wider adoption of this useful technique.
BACKGROUND: The unavailability of standardized parameters in bowel ultrasonography (US) commonly used in Crohn's disease (CD) and the shortage of skilled ultrasonographers are 2 limiting factors in the use of this imaging modality around the world. The aim of this study is to evaluate interobserver agreement among experienced sonographers in the evaluation of bowel US parameters in order to improve standardization in imaging reporting and interpretation. METHODS: Fifteen patients with an established diagnosis of CD underwent blinded bowel US performed by 6 experienced sonographers. Prior to the evaluation, the sonographers and clinical and radiological IBD experts met to formally define the US parameters. Interobserver agreement was tested with the Quatto method (s). RESULTS: All operators agreed on the presence/absence of CD lesions and distinguished absence of/mild activity or moderate/severe lesions in all patients. S values were moderate for bowel wall thickness (s = 0.48, P = n.s.), bowel wall pattern (s = 0.41, P = n.s.), vascularization (s = 0.52, P = n.s.), and presence of lymphnodes (s = 0.61, P = n.s.). Agreement was substantial for lesion location (s = 0.68, P = n.s.), fistula (s = 0.74, P = n.s.), phlegmon (s = 0.78, P = 0.04), and was almost perfect for abscess (s = 0.95, P = 0.02). Poor agreement was observed for mesenteric adipose tissue alteration, lesion extent, stenosis, and prestenotic dilation. CONCLUSIONS: In this study, the majority of the US parameters used in CD showed moderate/substantial agreement. The development of shared US imaging interpretation patterns among sonographers will lead to improved comparability of US results among centers and facilitate the development of multicenter studies and the spread of bowel US training, thereby allowing a wider adoption of this useful technique.
Authors: Shellie Jean Radford; Chris Clarke; Bethany Shinkins; Paul Leighton; Stuart Taylor; Gordon Moran Journal: Frontline Gastroenterol Date: 2021-06-23
Authors: Lenika Calavrezos; Peter Bannas; Malte Warncke; Christiane Wiegard; Samuel Huber; Carolin Manthey Journal: Ultrasound Int Open Date: 2022-09-26