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inter-observer Variability in the Detection and interpretation of Chest X-Ray Anomalies in Adults in an Endemic Tuberculosis Area

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Open Journal of Medical Imaging 2015年第3期5卷 143-149页

作者： Boniface Moifo Eric Walter Pefura-Yone Georges Nguefack-Tsague Marie Laure Gharingam Jean Roger Moulion Tapouh André-Pascal Kengne Samuel Nko’o Amvene Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon Department of Radiology and Radiation Oncology FMBS Yaoundé Cameroon Department of internal Medicine and Specialties’ FMBS Yaoundé Cameroon Service of Pneumology A Jamot Hospital of Yaoundé Yaoundé Cameroon Department of Public Health FMBS Yaoundé Cameroon South African Medical Research Council & University of Cape Town Cape Town South Africa

Purpose: To assess the inter-observer agreement in reading adults chest radiographs (CXR) and determine the effectiveness of observers in radiographic diagnosis of pulmonary tuberculosis (PTB) in a tuberculosis endemic area. Methods: A quasi-observational study was conducted in the Pneumology Department of Yaounde Jamot Hospital (Cameroon) from January to March 2014. This included six observers (two chest physicians, two radiologists, two end-training residents in medical imaging) and 47 frontal CXRs (4 of diffuse interstitial lung disease, 6 normal, 7 of lung cancers, 7 of bacterial pneumonia, 23 of PTB). The sample size was calculated on the basis of an expected 0.47 Kappa with a spread of 0.13 (α = 5%, CI = 95%) for six observers and five diagnostic items. The analysis of concordance was focused on the detection of nodules, cavitary lesions, pleural effusion, adenomegaly and diagnosis of PTB and lung cancer. These intervals of kappa coefficient were considered: discordance (0.81). Results: The average score for the detection of caverns was the highest (58.3%) followed by that of the correct diagnosis of tuberculosis (49.3%). Pneumologists had the highest proportions of correct diagnosis of tuberculosis (69.6% and 73.9%) and better inter-observer agreement (k = 0.71) for PTB diagnosis. observers were more in agreement for the detection of nodules (0.32 - 0.74), adenomegalies (0.43 - 0.69), and for the diagnosis of cancer (0.22 - 1) than for the diagnosis of tuberculosis (0.19 - 0.71). Disagreements were more frequent for the detection of pleural effusions (-0.08 - 0.73). Conclusion: The inter-observer agreement varies with the type of lesions and diagnosis. Pneumologists were most effective for the diagnosis of pulmonary tuberculosis. observers were more in agreement for the detection of nodules and the diagnosis of cancer than for the diagnosis of pulmonary tuberculosis.

关键词： inter-observer Variability Concordance Pulmonary Tuberculosis Nodules Caverns Lung Cancer Chest Radiography Kappa

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A Technical Note: inter-observer and inter-Modality Variability of Cone-Beam Computed Tomography (CBCT) and Ultrasound (US) in Stereotactic Body Radiotherapy for Kidney Cancer

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international Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第4期6卷 392-400页

作者： Ronnie W. K. Leung Matthew Y. P. Wong Venus W. Y. Lee Steven K. T. Cheung Aray K. L. Wong Hollis S. L. Luk Francesca K. L. Ng Gilbert M. L. Law Frankle K. H. Lee W. H. Mui Dennis Y. K. Ngar Department of Clinical Oncology Tuen Mun Hospital Hong Kong China

Introduction: To investigate the inter-observer and inter-modality variabilities of two imaging guided equipments—cone-beam computed tomography (CBCT) and ultrasound (US) in kidney stereotactic body radiotherapy. Methods: A renal metastasis case implanted with three gold anchor fiducial markers was firstly scanned by US to acquire a 3-dimension US image and followed by 4-dimension CBCT in every fraction. Seven observers retrospectively registered the pre-treatment images with the corresponding reference images based on the gold markers. Registration uncertainty of the observers between two imaging modalities was evaluated. Results: The uncertainties over whole treatment course in CBCT were 0.88 mm, 1.94 mm and 0.86 mm in lateral, longitudinal and vertical directions respectively;while 0.8 mm, 0.97 mm and 1.36 mm were found in US. Conclusion: The greatest uncertainty was found in longitudinal direction in CBCT due to the fact that the respiration motion is the most rigorous in cranial-caudal direction. In US, since the probe was hold almost in upright position, the strong echo in vertical direction was attributed to the greatest uncertainty for such direction.

关键词： inter-observer inter-Modality Variability CBCT US Kidney SBRT

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Reliability of the measurement of glenoid bone defect in anterior shoulder instability

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Chinese Medical Journal 2019年第21期132卷 2559-2564页

作者： Yong-Gang Wu Hai-Long Zhang Ya-Fei Hao Chun-Yan Jiang Department of Sports Medicine Peking University Fourth School of Clinical MedicineBeijing 100035China.

Background:The size of the glenoid bone defect is an important index in selecting the appropriate treatment for anterior shoulder ***,the reliability of glenoid bone defect measurement is *** purpose of the present study was to investigate the reliabilities of measurements of the glenoid bone defect on computed tomography and to explore the predisposing factors leading to inconsistency of these ***:The study population comprised 69 consecutive patients who underwent surgery for recurrent anterior shoulder dislocation in Peking University Fourth School of Clinical Medicine from March 2016 to January *** glenoid bone defect was measured by three surgeons on‘self-confirmed’and‘designated’3-D en-face views,and repeated after an interval of 3 *** included the ratio of the defect area to the best-fit circle area,and the ratio of the defect width to the diameter of the best-fit *** inter-and intra-observer reliabilities of the measurements were evaluated using intraclass correlation coefficients(ICCs).The maximum absolute inter-and intra-observer differences and the cumulative percentages of cases with inter-and intraobserver differences greater than these respective levels were ***:Almost all linear defect values were bigger than the areal defect *** inter-observer ICCs for the areal defect were 0.557 and 0.513 in the‘self-confirmed’group and 0.549 and 0.431 in the‘designated’*** inter-observer reliabilities for the linear defect were moderate or fair in the‘self-confirmed’group(ICC=0.446,0.374)and‘designated’group(ICC=0.402,0.327).The ICCs for intra-observer measurements were higher than those for inter-observer *** respective maximum interand intra-observer absolute differences were 13.9%and 13.2%in the‘self-confirmed’group,and 15.8%and 9.8%in the‘designated’***:The areal measurement of the glenoid bone defect is more reliable than the linear

关键词： Reliability Glenoid bone defect inter-observer Intra-observer Intra-class correlation coefficients Computed tomography

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Research on consistency of identifying solitary pulmonary masses with CT

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Journal of Nanjing Medical University 2008年第4期22卷 250-254页

作者： Qiuping Wang Gang Niu Yun Zhang Yongqian Qiang Zicheng Li Youmin Guo The imaging Center the First Affiliated Hospital medical school ofXi＇ an Jiaotong University Xi＇an 710061 Shaanxi Province China Imaging Center Shen-mu County Hospital Shen-mu 719300 Shaanxi Province China The imaging Center the Second Affiliated Hospital medical school of Xi＇an Jiaotong University Xi＇an 710004 Shaanxi

Objective：To research on consistency of identifying solitary pulmonary masses with CT. Methods：Three observers with different working backgrounds in imaging diagnosis individually interpreted the same group images of solitary pulmonary mass, by 12 indexes of objective signs. The differences in interpretation resulted in ante- and post-interpretations were assessed by the x^2 test. The agreement of two interpretations from the same observer was confirmed with the kappa test. A double-blind method was adopted for analysis. Results：The agreement rates of ante- and post-interpreting from the three observers were respectively 82.65%（486/588） 80.27%（472/ 588） and 84.86% （499/588） while their interpreting results were generally accordant without significant difference（x^2 = 4.975, df= 2, P= 0.083） however there was difference between the observer 2 and observer 3（x^2 = 4.875, df= 1, P = 0.027）. There were five indexes with k 〉 0.40 of ante- and post-interpreting results of the three observers, including clarity of nodule borderline, presence of sentus, uniformity of density, existence of cavity and calcification in pathological region, among them, the agreement rate of interpreting borderline and cavity was higher（k 〉 0.07）; the blood vessel convergence poorer（0 〈 k ≤ 0.40）; the other six CT signs of interpretation were slightly different. Conclusion：The ability to identify solitary pulmonary mass was inconsistent, and needs to be improved further.

关键词： pulmonary mass CT sign intro-observer inter-observer kappa index

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Predictive findings forHelicobacter pylori-uninfected, -infected and -eradicated gastric mucosa: Validation study

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World Journal of Gastroenterology 2013年第27期19卷 4374-4379页

作者： Kazuhiro Watanabe Naoyoshi Nagata Ryo Nakashima Etsuko Furuhata Takuro Shimbo Masao Kobayakawa Toshiyuki Sakurai Koh Imbe Ryota Niikura Chizu Yokoi Junichi Akiyama Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics National Center for Global Health and Medicine Department of Gastroenterology and Hepatology National Center for Global Health and MedicineKohnodai Hospital

AIM:To validate the usefulness of screening endoscopy findings for predictingHelicobacter pylori (H. pylori) infection status. METHODS:H. pylori infection status was determined by histology, serology, and the urea breast test in 77 consecutive patients who underwent upper endoscopy. Based on the findings, patients were categorized as H. pylori -uninfected, -infected, or -eradicated cases. Using six photos of certain sites in the stomach per case, we determined the presence or absence of the following endoscopic findings:regular arrangement of collecting venules (RAC), linear erythema, hemorrhage, fundic gland polyp (FGP), atrophic change, rugal hyperplasia, edema, spotty erythema, exudate, xanthoma, and mottled patchy erythema (MPE). The diagnostic odds ratio (DOR) and inter-observer agreement (Kappa value) for these 11 endoscopic findings used in the determination of H. pylori infection status were calculated. RESULTS:Of the 77 patients [32 men and 45 women; mean age (SD), 39.7 (13.4) years] assessed, 28 were H. pylori uninfected, 28 were infected, and 21 were eradicated. DOR values were significantly high (< 0.05) for the following H. pylori cases:uninfected cases with RAC (11.5), linear erythema (24.5), hemorrhage (4.1), and FGP (34.5); for infected cases with atrophic change (8.67), rugal hyperplasia (15.8), edema (14.2), spotty erythema (11.5), and exudate (3.52); and for eradicated cases with atrophic change (32.4) and MPE (103.0). Kappa values were excellent for FGP (0.93), good for RAC (0.63), hemorrhage (0.79), atrophic change (0.74), and MPE (0.75), moderate for linear erythema (0.51), rugal hyperplasia (0.49), edema (0.58), spotty erythema (0.47), and exudate (0.46), and poor for xanthoma (0.19). CONCLUSION:The endoscopic findings of RAC, hemorrhage, FGP, atrophic change, and MPE will be useful for predicting H. pylori infection status.

关键词： Diagnostic odds ratio Endoscopic finding Eradication therapy Helicobacter pylori inter-observer agreement

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