Die Inter- und Intraobservergenauigkeit der Strain-Elastographie in der Mammadiagnostik
Loading...
Date
Authors
Publisher
Abstract
Objective:
To evaluate the inter- and intrarater reliability of strain elastography in mammary diagnostic while comparing planes.
Methods:
Elasticity image acquisition in form of 918 elastograms with strain ratio values of 51 tumors (30 malignant, 21 benign) in 51 patients (mean age 55.9 ± 15.9 years; range 20 - 83 years) were prospectively measured by 3 blinded performers using combined B-mode sonography and strain elastography. The measurement was done 3 times each in two planes (horizontal and vertical) by every performer.
6 months later, the elasticity image interpretation was assigned through the same 3 observers using Tsukuba score values in a blinded random manner (total of 2754 Tsukuba scores values).
Results:
There were no statistically significant differences between examining in the horizontal vs. vertical plane (Strain-Ratio T-Test: p = 0.295 – 0.760, Tsukuba-Score: Wilcoxon-Test p = 0.066 - 0.853).
The interrater reliability of the strain ratio was categorized moderate (ICC 0.519-0.521) and the intrarater reliability substantial to almost perfect (ICC 0.621-0.844).
For the Tsukuba score, the elastograms measured and assessed specifically for everyday use showed a slight to fair interobserver reliability (ᴋ = 0.115-0.201). The interobserver reliability of the observer (ᴋ = 0.274-0.290) was slightly higher than the performer’s (ᴋ = 0.224-0.271).
At the best possible cut-off value of ≥ 1.8 (or ≥ 4), the strain ratio achieved a similarly high sensitivity as the Tsukuba score (68.0% vs. 68.1%) with higher specificity (65.9% vs. 62.2%).
Conclusion:
Strain elastography is a promising additional diagnostic tool, but due to slight to moderate interrater reliability it is not sufficient as a sole examination. There are signs of a possible improvement through quantification using stronger compression. Based on currently available results, it is recommended to use strain elastography with a single measurement of the strain ratio in one plane.
Review
Metadata
License
This item has been published with the following license: In Copyright