Do radiologists agree on findings in radiographer-acquired sonographic examinations?

OBJECTIVES: Sonographic examinations are usually regarded as observer dependent, but a recently introduced method using documentation with cine loops acquired in a standardized way attempts to address this problem. The aim of this study was to evaluate the intraobserver and interobserver agreement of sonographic liver examinations using strictly standardized examination protocols with cine loop documentation. METHODS: Ninety-eight outpatients were examined by a radiographer using the standardized method. Three radiologists, each with 10 to 20 years of experience in sonography, reviewed the cine loops retrospectively. After 4 weeks, the review was repeated; the 3 radiologists were blinded to the initial reading. The κ coefficient was used to analyze intraobserver and interobserver agreement, and agreement in percent was also calculated. RESULTS: The intraobserver agreement was highest for concrements in the gallbladder (κ= 0.91-0.96) and lowest when assessing the need for further examination (κ = 0.38-0.64). For increased liver echogenicity, κ varied between 0.73 and 0.92 and for skip areas between 0.73 and 0.90. The interobserver agreement was also highest for concrements in the gallbladder (κ = 0.84-1.00) and lowest for the need for further examination (κ = -0.12-0.46). For most other findings, substantial intraobserver agreement was found. CONCLUSIONS: For sonographic examinations performed according to a standardized examination protocol by a radiographer and viewed by an experienced radiologist, good interobserver agreement was found, except for judgments of the need for further examinations.

Radiographer-acquired and radiologist-reviewed ultrasound examination--agreement with radiologist's bedside evaluation.

BACKGROUND: Growing demand for ultrasound examinations and higher quality requirements motivate searching for routines combining the diagnostic accuracy of radiologist-performed examinations with the economical advantages of sonographer-performed examinations. One possible approach is to use strictly standardized acquisition and documentation schemes that give the radiologist access to all relevant information after the examination. PURPOSE: To compare a recently introduced routine, combining acquisition by a radiographer, documentation as standardized cine-loops, and review by a radiologist ('standardized method'), with the formerly used routine where the diagnosis is made bedside by the radiologist ('traditional method'). MATERIAL AND METHODS: In 64 policlinic patients, the kidneys (n=27) or the gallbladder (n=37) were examined with both the standardized and the traditional method. The radiologists' findings of hydronephrosis, tumors, cysts, echogenicity changes, and cortical thickness (in the kidneys), and wall thickness, concrements, and polyps (in the gallbladder) were compared between the methods with respect to agreement (proportion of agreement and kappa coefficient) as well as systematic differences (McNemar's test). RESULTS: The findings at the gallbladder examination showed a median agreement of 97% (86-100%; kappa=0.64-1.00), and those at the kidney examination, an agreement of 90% (78-100%; kappa=0.69-1.00). There were no significant systematic differences between the methods. CONCLUSION: The satisfactory agreement in this preliminary study indicates that the new workflow with ultrasound examinations performed by a radiographer and analyzed off-line by a radiologist is promising, and motivates further studies.

Visualization of liver lesions in standardized video-documented ultrasonography - inter-observer agreement and effect of contrast injection.

UNLABELLED: 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. CONCLUSIONS: 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.