AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive p...AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive proximal colon polyps size, removed in 2001, and originally as hyperplastic polyps by general at Indiana University, were reviewed in pathologists.CONCLUSION： Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.展开更多
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. Met...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.展开更多
Objective: Computer classification of sonographic BI-RADS features can aid differentiation of the malignant and benign masses. However, the variability in the diagnosis due to the differences in the observed features ...Objective: Computer classification of sonographic BI-RADS features can aid differentiation of the malignant and benign masses. However, the variability in the diagnosis due to the differences in the observed features between the observations is not known. The goal of this study is to measure the variation in sonographic features between multiple observations and determine the effect of features variation on computer-aided diagnosis of the breast masses. Materials and Methods: Ultrasound images of biopsy proven solid breast masses were analyzed in three independent observations for BI-RADS sonographic features. The BI-RADS features from each observation were used with Bayes classifier to determine probability of malignancy. The observer agreement in the sonographic features was measured by kappa coefficient and the difference in the diagnostic performances between observations was determined by the area under the ROC curve, Az, and interclass correlation coefficient. Results: While some features were repeatedly observed, κ = 0.95, other showed a significant variation, κ = 0.16. For all features, combined intra-observer agreement was substantial, κ = 0.77. The agreement, however, decreased steadily to 0.66 and 0.56 as time between the observations increased from 1 to 2 and 3 months, respectively. Despite the variation in features between observations the probabilities of malignancy estimates from Bayes classifier were robust and consistently yielded same level of diagnostic performance, Az was 0.772-0.817 for sonographic features alone and 0.828-0.849 for sonographic features and age combined. The difference in the performance, ΔAz, between the observations for the two groups was small (0.003-0.044) and was not statistically significant (p < 0.05). Interclass correlation coefficient for the observations was 0.822 (CI: 0.787-0.853) for BI-RADS sonographic features alone and for those combined with age was 0.833 (CI: 0.800-0.862). Conclusion: Despite the differences in the BI-RADS sonographic features between dif展开更多
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 endemi...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.展开更多
Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Com...Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Computed Tomography PET_CT scan according to Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria. Method and Materials: Forty-four consecutive patients of prostate cancer were prospectively studied between the duration of January 2021 to June 2021 at Institute of Nuclear Medicine and Oncology (INMOL), Lahore. All PET-CT scans were assessed by a researcher and 3 nuclear physicians and divided into two groups, interpreted in two phases. In the first phase, each group independently evaluated the scans while in the second phase, a consensus meeting was held and all the cases with discordance were discussed. Cohen’s Kappa test was used to measure interobserver variability with the cut-off of K’s alpha Results: The study showed 41 out of 44 scans with positive PSMA findings while 03 scans were negative for any PSMA avid disease. In the first phase of image analysis, the level of agreement was slight in T stage (Kappa = 0.068, p = 0.65), moderate in the miN stage (Kappa = 0.46, p = 0.02) and substantial in miM stage (Kappa = 0.77, p ≤ 0.001) was seen. For PSMA score, overall agreement was substantial agreement (Kappa = 0.64, p Conclusion: Remarkable inter-observer agreement was seen in PROMISE criteria.展开更多
<strong>Purpose:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Radiotherapy is a widely accepted standard of care for early-sta...<strong>Purpose:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Radiotherapy is a widely accepted standard of care for early-stage prostate cancer, and it is believed that the plan quality and treatment outcome are associated with contour accuracy of both the target and organs-at-risk (OAR). The purposes of this study are to 1) assess geometric and dosimetric uncertainties due to inter-observer contour variabilities and 2) evaluate the effectiveness of geometric indicators to predict target dosimetry in prostate radiotherapy. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Twenty prostate patients were selected for this retrospective study. Five experienced clinicians created unique structure sets containing prostate, seminal vesicles, bladder, and rectum for each patient. A fully automated script and knowledge-based planning routine were utilized to create standardized and unbiased plans that could be used to evaluate changes in isodose distributions due to inter-observer variability in structure segmentation. Plans were created on a “gold-standard” structure set, as well as on each of the user-defined structure sets. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Inter-observer variability of contours during structure segmentation was very low for clearly defined organs such as the bladder but increased for organs without well-defined borders (prostate, seminal vesicles, and rectum). For plans generated with the user-defined structure sets, strong/moderate correlations were observed between the geometric indicators for target structure agreement and target coverage for both low-risk and intermediate-risk patient groups, while OAR indicators showed no correlation to final dosimetry. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Target delineation is crucial in order to maintain adequate dosimetric coverage regardless o展开更多
文摘AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive proximal colon polyps size, removed in 2001, and originally as hyperplastic polyps by general at Indiana University, were reviewed in pathologists.CONCLUSION： Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.
文摘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.
文摘Objective: Computer classification of sonographic BI-RADS features can aid differentiation of the malignant and benign masses. However, the variability in the diagnosis due to the differences in the observed features between the observations is not known. The goal of this study is to measure the variation in sonographic features between multiple observations and determine the effect of features variation on computer-aided diagnosis of the breast masses. Materials and Methods: Ultrasound images of biopsy proven solid breast masses were analyzed in three independent observations for BI-RADS sonographic features. The BI-RADS features from each observation were used with Bayes classifier to determine probability of malignancy. The observer agreement in the sonographic features was measured by kappa coefficient and the difference in the diagnostic performances between observations was determined by the area under the ROC curve, Az, and interclass correlation coefficient. Results: While some features were repeatedly observed, κ = 0.95, other showed a significant variation, κ = 0.16. For all features, combined intra-observer agreement was substantial, κ = 0.77. The agreement, however, decreased steadily to 0.66 and 0.56 as time between the observations increased from 1 to 2 and 3 months, respectively. Despite the variation in features between observations the probabilities of malignancy estimates from Bayes classifier were robust and consistently yielded same level of diagnostic performance, Az was 0.772-0.817 for sonographic features alone and 0.828-0.849 for sonographic features and age combined. The difference in the performance, ΔAz, between the observations for the two groups was small (0.003-0.044) and was not statistically significant (p < 0.05). Interclass correlation coefficient for the observations was 0.822 (CI: 0.787-0.853) for BI-RADS sonographic features alone and for those combined with age was 0.833 (CI: 0.800-0.862). Conclusion: Despite the differences in the BI-RADS sonographic features between dif
文摘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.
文摘Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Computed Tomography PET_CT scan according to Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria. Method and Materials: Forty-four consecutive patients of prostate cancer were prospectively studied between the duration of January 2021 to June 2021 at Institute of Nuclear Medicine and Oncology (INMOL), Lahore. All PET-CT scans were assessed by a researcher and 3 nuclear physicians and divided into two groups, interpreted in two phases. In the first phase, each group independently evaluated the scans while in the second phase, a consensus meeting was held and all the cases with discordance were discussed. Cohen’s Kappa test was used to measure interobserver variability with the cut-off of K’s alpha Results: The study showed 41 out of 44 scans with positive PSMA findings while 03 scans were negative for any PSMA avid disease. In the first phase of image analysis, the level of agreement was slight in T stage (Kappa = 0.068, p = 0.65), moderate in the miN stage (Kappa = 0.46, p = 0.02) and substantial in miM stage (Kappa = 0.77, p ≤ 0.001) was seen. For PSMA score, overall agreement was substantial agreement (Kappa = 0.64, p Conclusion: Remarkable inter-observer agreement was seen in PROMISE criteria.
文摘<strong>Purpose:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Radiotherapy is a widely accepted standard of care for early-stage prostate cancer, and it is believed that the plan quality and treatment outcome are associated with contour accuracy of both the target and organs-at-risk (OAR). The purposes of this study are to 1) assess geometric and dosimetric uncertainties due to inter-observer contour variabilities and 2) evaluate the effectiveness of geometric indicators to predict target dosimetry in prostate radiotherapy. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Twenty prostate patients were selected for this retrospective study. Five experienced clinicians created unique structure sets containing prostate, seminal vesicles, bladder, and rectum for each patient. A fully automated script and knowledge-based planning routine were utilized to create standardized and unbiased plans that could be used to evaluate changes in isodose distributions due to inter-observer variability in structure segmentation. Plans were created on a “gold-standard” structure set, as well as on each of the user-defined structure sets. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Inter-observer variability of contours during structure segmentation was very low for clearly defined organs such as the bladder but increased for organs without well-defined borders (prostate, seminal vesicles, and rectum). For plans generated with the user-defined structure sets, strong/moderate correlations were observed between the geometric indicators for target structure agreement and target coverage for both low-risk and intermediate-risk patient groups, while OAR indicators showed no correlation to final dosimetry. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Target delineation is crucial in order to maintain adequate dosimetric coverage regardless o
