Interobserver Agreement Between Primary Sonographers and Secondary Overreaders for Screening and Surveillance Liver Ultrasounds Using Ultrasound Liver Imaging Reporting and Data System.

ABSTRACT: The authors aim to identify if primary sonographers and secondary reviewers, both radiologists and sonographers, are likely to assign the same Ultrasound Liver Imaging Reporting and Data System (US LI-RADS) scores for liver surveillance ultrasounds. Institutional review board approval was obtained. Sonographers were familiarized with US LI-RADS via radiologist-led lectures. Three sonographers prospectively scored 170 screening examinations using US LI-RADS recommendations. Scans were retrospectively rescored by a fourth sonographer and a radiologist, both of whom were blinded to the original scores. Results were analyzed with weighted and nonweighted Cohen kappa statistical analysis methods. There was near-perfect agreement between primary and secondary sonographers and primary sonographer and radiologist (kappa of 0.87 and 0.92, respectively) for US LI-RADS category (cat) scores. However, only substantial and moderate agreements were noted for visualization (vis) scores between primary and secondary sonographers and primary sonographer and radiologist (weighted kappa of 0.73 and 0.48, respectively). There was vis score disagreement between the primary sonographer and radiologist in 60 (35.3%) cases. In 35 (20%) cases, the radiologist assigned a lower/more conservative vis score. There was vis score disagreement between the primary and secondary reviewing sonographers in 30 (17.6%) cases. In 12 (7%) cases, the secondary sonographer assigned a more conservative vis score. Although a good degree of concordance was noted between the groups, radiologists will need to generate their own US LI-RADS scoring to accurately reflect their impression and appropriately steer management.

Role of Ultrasound for Chronic Liver Disease and Hepatocellular Carcinoma Surveillance.

Ultrasound plays a vital role in the evaluation of patients with chronic liver disease and in hepatocellular carcinoma (HCC) surveillance in populations at risk for developing HCC. Semiannual ultrasound for HCC surveillance is universally recommended by all liver societies around the world. Advanced ultrasound techniques, such as elastography and contrast-enhanced ultrasound, offer additional benefits in imaging evaluation of chronic liver disease. Major benefits of ultrasound include its high safety profile and relatively low cost.

Correlation of placental MR imaging signs and pathologic diagnosis of placenta accreta spectrum: Retrospective single center case series.

INTRODUCTION: Alongside initial screening obstetric US, use of placental MRI has been increasing in the last few decades to aid with antenatal diagnosis and delivery planning in Placenta Accreta Spectrum (PAS). The aim of this study was to determine if the MRI pathophysiological sign subcategories described in the current literature can predict the severity of pathologic diagnosis. METHODS: Institutional imaging records were reviewed for placental MRIs performed for suspicion of PAS in the last decade. Electronic health records were searched for patient history and pathology. The 59 MRI studies were reviewed using the 11 MRI signs described by the SAR and ESUR joint consensus statement. Further breakdown of the signs was divided by underlying pathophysiologic subcategories including gross morphologic, interface and tissue architecture signs. RESULTS: Pathologic diagnosis yielded 34 cases: accreta 4/34, incerta 14/34, percreta 10/34 and normal 6/34. Of the accreta cases all of them demonstrated at least two interface and half of the cases had tissue architecture signs, 13/14 increta cases demonstrated interface signs and 12/14 demonstrated tissue architecture signs, 9/10 percreta cases had two interface and at least six demonstrated three tissue architecture signs. Statistical analysis showed significant difference between pathologic diagnosis and the number of positive interface signs with p = 0.02. DISCUSSION: Interface signs were the most objective and sensitive MRI subcategory. Statistical analysis determined there was a significant difference between PAS diagnosis and number of interface signs present. This subcategory has the most overlap with classic US signs which are traditionally used before MRI referral.

Reporting of acute pancreatitis by radiologists-time for a systematic change with structured reporting template.

Acute pancreatitis has a wide array of imaging presentations. Various classifications have been used in the past to standardize the terminology and reduce confusing and redundant terms. We aim to review the historical and current classifications of acute pancreatitis and propose a new reporting template which can improve communication between various medical teams by use of appropriate terminology and structured radiology template. The standardized reporting template not only conveys the most important imaging findings in a simplified yet comprehensive way but also allows structured data collection for future research and teaching purposes.