Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions
Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnosti...
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| Veröffentlicht in: | TURKISH JOURNAL OF MEDICAL SCIENCES 2021-04, Vol.51 (2), p.547-554 |
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| creator | Turnaoğlu, Hale Haberal, Kemal Murat Arslan, Serdar Yavuz Çolak, Meriç Ulu Öztürk, Funda Uslu, Nihal |
| description | Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography.
A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations.
There was very good agreement (weighted κ = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted κ = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers’ diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively).
In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals. |
| doi_str_mv | 10.3906/sag-2006-257 |
| format | Article |
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A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations.
There was very good agreement (weighted κ = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted κ = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers’ diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively).
In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.</description><identifier>ISSN: 1303-6165</identifier><identifier>ISSN: 1300-0144</identifier><identifier>EISSN: 1303-6165</identifier><identifier>DOI: 10.3906/sag-2006-257</identifier><identifier>PMID: 32950046</identifier><language>eng</language><publisher>Turkey: The Scientific and Technological Research Council of Turkey</publisher><subject>Adult ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - pathology ; Elasticity Imaging Techniques ; Female ; Humans ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography, Mammary - methods</subject><ispartof>TURKISH JOURNAL OF MEDICAL SCIENCES, 2021-04, Vol.51 (2), p.547-554</ispartof><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><rights>Copyright © 2021 The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-eae5e89ba6058d227671169a9e0ea295761e7adece9ce83109cc5e4b04483f693</citedby><orcidid>0000-0002-8211-4065 ; 0000-0002-0294-6874 ; 0000-0002-8439-8700 ; 0000-0001-7984-4326 ; 0000-0003-2782-2824 ; 0000-0002-0781-0036</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203122/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203122/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32950046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Turnaoğlu, Hale</creatorcontrib><creatorcontrib>Haberal, Kemal Murat</creatorcontrib><creatorcontrib>Arslan, Serdar</creatorcontrib><creatorcontrib>Yavuz Çolak, Meriç</creatorcontrib><creatorcontrib>Ulu Öztürk, Funda</creatorcontrib><creatorcontrib>Uslu, Nihal</creatorcontrib><title>Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions</title><title>TURKISH JOURNAL OF MEDICAL SCIENCES</title><addtitle>Turk J Med Sci</addtitle><description>Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography.
A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations.
There was very good agreement (weighted κ = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted κ = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers’ diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively).
In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.</description><subject>Adult</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - pathology</subject><subject>Elasticity Imaging Techniques</subject><subject>Female</subject><subject>Humans</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonography, Mammary - methods</subject><issn>1303-6165</issn><issn>1300-0144</issn><issn>1303-6165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUctOwzAQtBCIlsKNM8oHEPAjceILEqp4VKrEBc7WJtm0Rmkc2W6lip_HpVCV03pnZ2ZtDyHXjN4JReW9h0XKKZUpz4sTMmaCilQymZ8enUfkwvtPSrnIcnVORoKrnNJMjsnXrA_obOXRbdAl0DeJ2SErDEvbJBtwBirTmbCNeNJAgP18cBggGNsntk0qh-BD4oODSMIuNnbhYFj-iPzaD6Y2du3_iB36qPSX5KyFzuPVb52Qj-en9-lrOn97mU0f52ktyiykCJhjqSqQNC8bzgtZMCYVKKQI8SGFZFhAgzWqGkvBqKrrHLOKZlkpWqnEhDzsfYd1tcKmxj5etNODMytwW23B6P-T3iz1wm50yalgnEeD271B7az3DtuDllG9C0HHEPQuBB1DiPSb430H8t-vi2-bm4hE</recordid><startdate>20210430</startdate><enddate>20210430</enddate><creator>Turnaoğlu, Hale</creator><creator>Haberal, Kemal Murat</creator><creator>Arslan, Serdar</creator><creator>Yavuz Çolak, Meriç</creator><creator>Ulu Öztürk, Funda</creator><creator>Uslu, Nihal</creator><general>The Scientific and Technological Research Council of Turkey</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8211-4065</orcidid><orcidid>https://orcid.org/0000-0002-0294-6874</orcidid><orcidid>https://orcid.org/0000-0002-8439-8700</orcidid><orcidid>https://orcid.org/0000-0001-7984-4326</orcidid><orcidid>https://orcid.org/0000-0003-2782-2824</orcidid><orcidid>https://orcid.org/0000-0002-0781-0036</orcidid></search><sort><creationdate>20210430</creationdate><title>Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions</title><author>Turnaoğlu, Hale ; Haberal, Kemal Murat ; Arslan, Serdar ; Yavuz Çolak, Meriç ; Ulu Öztürk, Funda ; Uslu, Nihal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-eae5e89ba6058d227671169a9e0ea295761e7adece9ce83109cc5e4b04483f693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - pathology</topic><topic>Elasticity Imaging Techniques</topic><topic>Female</topic><topic>Humans</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonography, Mammary - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Turnaoğlu, Hale</creatorcontrib><creatorcontrib>Haberal, Kemal Murat</creatorcontrib><creatorcontrib>Arslan, Serdar</creatorcontrib><creatorcontrib>Yavuz Çolak, Meriç</creatorcontrib><creatorcontrib>Ulu Öztürk, Funda</creatorcontrib><creatorcontrib>Uslu, Nihal</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>TURKISH JOURNAL OF MEDICAL SCIENCES</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Turnaoğlu, Hale</au><au>Haberal, Kemal Murat</au><au>Arslan, Serdar</au><au>Yavuz Çolak, Meriç</au><au>Ulu Öztürk, Funda</au><au>Uslu, Nihal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions</atitle><jtitle>TURKISH JOURNAL OF MEDICAL SCIENCES</jtitle><addtitle>Turk J Med Sci</addtitle><date>2021-04-30</date><risdate>2021</risdate><volume>51</volume><issue>2</issue><spage>547</spage><epage>554</epage><pages>547-554</pages><issn>1303-6165</issn><issn>1300-0144</issn><eissn>1303-6165</eissn><abstract>Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography.
A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations.
There was very good agreement (weighted κ = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted κ = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers’ diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively).
In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.</abstract><cop>Turkey</cop><pub>The Scientific and Technological Research Council of Turkey</pub><pmid>32950046</pmid><doi>10.3906/sag-2006-257</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8211-4065</orcidid><orcidid>https://orcid.org/0000-0002-0294-6874</orcidid><orcidid>https://orcid.org/0000-0002-8439-8700</orcidid><orcidid>https://orcid.org/0000-0001-7984-4326</orcidid><orcidid>https://orcid.org/0000-0003-2782-2824</orcidid><orcidid>https://orcid.org/0000-0002-0781-0036</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Elasticity Imaging Techniques Female Humans Retrospective Studies ROC Curve Sensitivity and Specificity Ultrasonography, Mammary - methods |
| title | Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions |
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