scholarly journals Intra- and Interobserver Reliability and Variability of Femoral Artery Pseudoaneurysm Measurements Between Pre- and Postprocessed B-mode Sonographic Images

2018 ◽  
Vol 35 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Reham Kaifi ◽  
Lauren Price ◽  
Andrew Chen ◽  
Babak Sarani ◽  
Vesna Zderic

The objective was to enhance the contrast and segment the femoral artery pseudoaneurysm (FAP) area from patients’ ultrasonography (US) images. In addition, this study compared the intra- and interobserver reliability and variability of the FAP measurements from the original, contrast-enhanced, and segmented US. Retrospectively, 25 FAP sonograms were evaluated by four observers (two trained and two novice). They twice measured the FAP body width, neck width, and length from original, enhanced, and segmented US. The intra- and interobserver reliability for measuring FAP body width, neck width, and neck length improved by 10% after enhancing the original 2D US contrast and segmenting the region of interest across all observers. Also, the intra- and interobserver variability among measurements across all observers decreased by 44%. Using US processing was more profound for novice observers (intraclass correlation coefficient [ICC], 0.76–0.93) compared to trained observers (ICC, 0.94–0.99). US postprocessing resulted in a decrease in variability for FAP measurements.

2020 ◽  
Vol 36 (3) ◽  
pp. 212-222
Author(s):  
Reham Kaifi ◽  
Mohammed Almatrafi ◽  
Ferdos Alahmary ◽  
Andrew Chen ◽  
Robyn Macsata ◽  
...  

Objective: To assess the reliability and variability of femoral artery pseudoaneurysm (FAP) measurements between pre- and postprocessed sonograms acquired in a major medical center in Saudi Arabia as compared with results obtained from a major medical center in the United States. Methods: Retrospective image analysis was conducted on 23 FAP sonograms, which were evaluated by four observers. Observers measured FAP sac and neck from pre- and postprocessed images and remeasured again after 2 weeks, to avoid recall bias. Results: The use of image processing was more profound for the novice observers in measuring FAP neck width and length. The intraclass correlation coefficient (ICC) for FAP neck width improved after segmentation from 0.63 to 0.91; in contrast, the ICC improved from 0.91 to 0.97 for experts. The average ICCs for FAP neck length improved from 0.40 to 0.79 for novices and from 0.86 to 0.95 for experts. The largest variation of values, within observers, were for neck length obtained from the original images. The range varied from 0.16 to 0.37 cm and was reduced to 0.10 to 0.18 cm with segmented images. Conclusion: As demonstrated previously, sonographic image processing resulted in increased reliability and decreased variability for FAP measurements.


2017 ◽  
Vol 03 (03) ◽  
pp. E99-E106 ◽  
Author(s):  
Marcus Stangeland ◽  
Trond Engjom ◽  
Martin Mezl ◽  
Radovan Jirik ◽  
Odd Gilja ◽  
...  

Abstract Purpose Dynamic contrast-enhanced ultrasound (DCE-US) can be used for calculating organ perfusion. By combining bolus injection with burst replenishment, the actual mean transit time (MTT) can be estimated. Blood volume (BV) can be obtained by scaling the data to a vessel on the imaging plane. The study aim was to test interobserver agreement for repeated recordings using the same ultrasound scanner and agreement between results on two different scanner systems. Materials and Methods Ten patients under evaluation for exocrine pancreatic failure were included. Each patient was scanned two times on a GE Logiq E9 scanner, by two different observers, and once on a Philips IU22 scanner, after a bolus of 1.5 ml Sonovue. A 60-second recording of contrast enhancement was performed before the burst and the scan continued for another 30 s for reperfusion. We performed data analysis using MATLAB-based DCE-US software. An artery in the same depth as the region of interest (ROI) was used for scaling. The measurements were compared using the intraclass correlation coefficient (ICC) and Bland Altman plots. Results The interobserver agreement on the Logiq E9 for MTT (ICC=0.83, confidence interval (CI) 0.46–0.96) was excellent. There was poor agreement for MTT between the Logiq E9 and the IU22 (ICC=−0.084, CI −0.68–0.58). The interobserver agreement for blood volume measurements was excellent on the Logiq E9 (ICC=0.9286, CI 0.7250–0.98) and between scanners (ICC=0.86, CI=0.50–0.97). Conclusion Interobserver agreement was excellent using the same scanner for both parameters and between scanners for BV, but the comparison between two scanners did not yield acceptable agreement for MTT. This was probably due to incomplete bursting of bubbles in some of the recordings on the IU22.


2020 ◽  
Vol 14 (1) ◽  
pp. 27-35
Author(s):  
Sutasinee Kongpromsuk ◽  
Nantaporn Pitakvej ◽  
Nutchawan Jittapiromsak ◽  
Supada Prakkamakul

AbstractBackgroundAccurate identification of brain metastases is crucial for cancer treatment.ObjectivesTo compare the ability to detect brain metastases of two alternative types of contrast-enhanced three-dimensional (3D) T1-weighted sequences called SPACE (Sampling Perfection with Application optimized Contrasts using different flip angle Evolutions) and VIBE (Volumetric Interpolated Brain Sequence) on magnetic resonance imaging (MRI) at 3 tesla.MethodsBetween April 2017 and February 2018, 27 consecutive adult Thai patients with a total number of 424 brain metastases were retrospectively included. The patients underwent both contrast-enhanced 3D T1-weighted SPACE and 3D T1-weighted VIBE MRI sequences at 3 tesla. Two neuroradiology experts independently reviewed the images to determine the number of enhancing lesions on each sequence. Wilcoxon signed rank test was used to compare the difference between the numbers of detectable parenchymal enhancing lesions. Interobserver reliability was calculated using intraclass correlation.Results3D T1-weighted SPACE detected more parenchymal enhancing lesions than 3D T1-weighted VIBE (424 vs. 378 lesions, median 6 vs. 5, P = 0.008). Fifteen patients (55.6%) had equal number of parenchymal enhancing lesions between two sequences. 3D T1-weighted SPACE detected more parenchymal enhancing lesions (up to 9 more lesions) in 10 patients (37%), while 3D T1-weighted VIBE detected more enhancing lesions (up to 2 more lesions) in 2 patients (7.4%). Interobserver reliability between the readers was excellent.ConclusionContrast-enhanced 3D T1-weighted SPACE sequence demonstrates a higher ability to detect brain metastases than contrast-enhanced 3D T1-weighted VIBE sequence at 3 tesla.


1991 ◽  
Vol 34 (5) ◽  
pp. 989-999 ◽  
Author(s):  
Stephanie Shaw ◽  
Truman E. Coggins

This study examines whether observers reliably categorize selected speech production behaviors in hearing-impaired children. A group of experienced speech-language pathologists was trained to score the elicited imitations of 5 profoundly and 5 severely hearing-impaired subjects using the Phonetic Level Evaluation (Ling, 1976). Interrater reliability was calculated using intraclass correlation coefficients. Overall, the magnitude of the coefficients was found to be considerably below what would be accepted in published behavioral research. Failure to obtain acceptably high levels of reliability suggests that the Phonetic Level Evaluation may not yet be an accurate and objective speech assessment measure for hearing-impaired children.


2020 ◽  
Vol 50 (1) ◽  
pp. 59-68
Author(s):  
Sevtap Tugce Ulas ◽  
Kay Geert Hermann ◽  
Marcus R. Makowski ◽  
Robert Biesen ◽  
Fabian Proft ◽  
...  

Abstract Objective To evaluate the performance of dynamic contrast-enhanced CT (DCE-CT) in detecting and quantitatively assessing perfusion parameters in patients with arthritis of the hand compared with dynamic contrast-enhanced MRI (DCE-MRI) as a standard of reference. Materials and methods In this IRB-approved randomized prospective single-centre study, 36 consecutive patients with suspected rheumatoid arthritis underwent DCE-CT (320-row, tube voltage 80 kVp, tube current 8.25 mAs) and DCE-MRI (1.5 T) of the hand. Perfusion maps were calculated separately for mean transit time (MTT), time to peak (TTP), relative blood volume (rBV), and relative blood flow (rBF) using four different decomposition techniques. Region of interest (ROI) analysis was performed in metacarpophalangeal joints II–V and in the wrist. Pairs of perfusion parameters in DCE-CT and DCE-MRI were compared using a two-tailed t test for paired samples and interpreted for effect size (Cohen’s d). According to the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) scoring results, differentiation of synovitis-positive and synovitis-negative joints with both modalities was assessed with the independent t test. Results The two modalities yielded similar perfusion parameters. Identified differences had small effects (d 0.01–0.4). DCE-CT additionally differentiates inflamed and noninflamed joints based on rBF and rBV but tends to underestimate these parameters in severe inflammation. The total dose-length product (DLP) was 48 mGy*cm with an estimated effective dose of 0.038 mSv. Conclusion DCE-CT is a promising imaging technique in arthritis. In patients with a contraindication to MRI or when MRI is not available, DCE-CT is a suitable alternative to detect and assess arthritis.


1992 ◽  
Vol 11 (4) ◽  
pp. 182-183 ◽  
Author(s):  
M Shapiro ◽  
H L Cohen ◽  
K Crystal ◽  
D Katz

2021 ◽  
Vol 09 (02) ◽  
pp. E130-E136
Author(s):  
María Belvis Jiménez ◽  
Pedro Hergueta-Delgado ◽  
Blas Gómez Rodríguez ◽  
Belén Maldonado Pérez ◽  
Luisa Castro Laria ◽  
...  

Abstract Background and study aims: Endoscopy plays an essential role in managing patients with ulcerative colitis (UC), as it allows us to visualize and assess the severity of the disease. As such assessments are not always objective, different scores have been devised to standardize the findings. The main aim of this study was to assess the interobserver variability between the Mayo Endoscopy Score (MES), Ulcerative Colitis Endoscopy Index of Severity (UCEIS) and Ulcerative Colitis Colonoscopy Index of Severity (UCCIS) analyzing the severity of the endoscopic lesions in patients with ulcerative colitis. Patients and methods: This was a single-cohort observational study in which a colonoscopy was carried out on patients with UC, as normal clinical practice, and a video was recorded. The results from the video were classified according to the MES, UCEIS and UCCIS by three endoscopic specialists independently, and they were compared to each other. The Mayo Endoscopy Score (MES) was used to assess the clinical situation of the patient. The therapeutic impact was analyzed after colonoscopy was carried out. Results: Sixty-seven patients were included in the study. The average age was 51 (SD ± 16.7) and the average MES was 3.07 (SD ± 2.54). The weighted Kappa index between endoscopists A and B for the MES was 0.8; between A and C 0.52; and between B and C 0.49. The intraclass correlation coefficient for UCEIS was 0.92 among the three endoscopists (CI 95 %: 0.83–0.96) and 0.96 for UCCIS among the three endoscopists (CI 95 % 0.94–0.97). A change in treatment for 34.3 % of the patients was implemented on seeing the results of the colonoscopy. Conclusions: There was an adequate, but not perfect, correlation between the different endoscopists for MES, UCEIS, UCCIS. This was higher with the last two scores. Thus, there is still some subjectivity to be minimized through special training, on assessing the seriousness of the endoscopic lesions in patients with UC.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minjeong Kim ◽  
Ja Young Oh ◽  
Seon Ha Bae ◽  
Seung Hyeun Lee ◽  
Won Jun Lee ◽  
...  

AbstractWe evaluated the reliability and validity of the 5-scale grading system to interpret the point-of-care immunoassay for tear matrix metalloproteinase (MMP)-9. Six observers graded red bands of photographs of the readout window in MMP-9 immunoassay kit (InflammaDry) two times with 2-week interval based on the 5-scale grading system (i.e. grade 0–4). Interobserver and intraobserver reliability were evaluated using intraclass correlation coefficients. The interobserver agreements were analyzed according to the severity of tear MMP-9 expression. To validate the system, a concentration calibration curve was made using MMP-9 solutions with reference concentrations, then the distribution of MMP-9 concentrations was analyzed according to the 5-scale grading system. Both intraobserver and interobserver reliability was excellent. The readout grades were significantly correlated with the quantified colorimetric densities. The interobserver variance of readout grades had no correlation with the severity of the measured densities. The band density continued to increase up to a maximal concentration (i.e. 5000 ng/mL) according to the calibration curve. The difference of grades reflected the change of MMP-9 concentrations sensitively, especially between grade 2 and 4. Together, our data indicate that the subjective 5-scale grading system in the point-of-care MMP-9 immunoassay is an easy and reliable method with acceptable accuracy.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aristeidis A. Villias ◽  
Stefanos G. Kourtis ◽  
Hercules C. Karkazis ◽  
Gregory L. Polyzois

Abstract Background The replica technique with its modifications (negative replica) has been used for the assessment of marginal fit (MF). However, identification of the boundaries between prosthesis, cement, and abutment is challenging. The recently developed Digital Image Analysis Sequence (DIAS) addresses this limitation. Although DIAS is applicable, its reliability has not yet been proven. The purpose of this study was to verify the DIAS as an acceptable method for the quantitative assessment of MF at cemented crowns, by conducting statistical tests of agreement between different examiners. Methods One hundred fifty-one implant-supported experimental crowns were cemented. Equal negative replicas were produced from the assemblies. Each replica was sectioned in six parts, which were photographed under an optical microscope. From the 906 standardized digital photomicrographs (0.65 μm/pixel), 130 were randomly selected for analysis. DIAS included tracing the profile of the crown and the abutment and marking the margin definition points before cementation. Next, the traced and marked outlines were superimposed on each digital image, highlighting the components’ boundaries and enabling MF measurements. One researcher ran the analysis twice and three others once, independently. Five groups of 130 measurements were formed. Intra- and interobserver reliability was evaluated with intraclass correlation coefficient (ICC). Agreement was estimated with the standard error of measurement (SEM), the smallest detectable change at the 95% confidence level (SDC95%), and the Bland and Altman method of limits of agreement (LoA). Results Measured MF ranged between 22.83 and 286.58 pixels. Both the intra- and interobserver reliability were excellent, ICC = 1 at 95% confidence level. The intra- and interobserver SEM and SDC95% were less than 1 and 3 pixels, respectively. The Bland–Altman analysis presented graphically high level of agreement between the mean measurement of the first observer and each of the three other observers’ measurements. Differences between observers were normally distributed. In all three cases, the mean difference was less than 1 pixel and within ± 3 pixels LoA laid at least 95% of differences. T tests of the differences did not reveal any fixed bias (P > .05, not significant). Conclusion The DIAS is an objective and reliable method able to detect and quantify MF at ranges observed in clinical practice.


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