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Observer variability in the sonographic evaluation of thyroid nodules
Author(s) -
Park Chang Suk,
Kim Sung Hun,
Jung So Lyung,
Kang Bong Joo,
Kim Jee Young,
Choi Jae Jung,
Sung Mi Suk,
Yim Hyeon Woo,
Jeong Seung Hee
Publication year - 2010
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20689
Subject(s) - medicine , thyroid nodules , echogenicity , radiology , neuroradiology , predictive value , nodule (geology) , kappa , thyroid , concordance , predictive value of tests , calcification , nuclear medicine , differential diagnosis , cohen's kappa , diagnostic accuracy , ultrasound , pathology , mathematics , paleontology , statistics , geometry , neurology , psychiatry , biology
Objective. Inter‐ and intraobserver variabilities in the description and diagnostic categorization of sonographic (US) features of thyroid nodules were evaluated. Methods. The current study was conducted on 72 malignant nodules and 61 benign nodules. The US findings for each thyroid nodule were analyzed twice at a 6‐week interval by five radiologists. The analyses were in accordance with the guidelines proposed bythe Thyroid Study Group of the Korean Society of Neuroradiology and Head and Neck Radiology (TSGKSNRHNR). Inter‐ and intraobserver variabilities were calculated using Cohen's kappa statistics. The sensitivity, specificity, positive‐predictive value, and negative‐predictive value in the assessment of the diagnostic accuracy using these guidelines were calculated. Result. The interobserver agreement was fair to substantial for US features and categorization. Of the US features of the thyroid nodules, internal content (solid versus cystic) showed substantial agreement (k= 0.64). There was moderate agreement with regard to shape, echogenicity, calcification, and diagnostic categories (k = 0.42, 0.57, 0.55, and 0.55, respectively). There was fair agreement for margin, echotexture, and capsule invasion (k = 0.34, 0.26, and 0.32, respectively). With regard to intraobserver agreement, there was moderate to substantial agreement for all US features except for echotexture and capsule invasion, which showed fair agreement. In particular, there was moderate to almost perfect agreement for the diagnostic category. The sensitivity, specificity, positive‐predictive value, and negative‐predictive value were 65.3%–81.9%, 60.7%–68.9%, 69.7%–73.8%, and 66.6%–75.5%, respectively. Conclusion. There were high degrees of inter‐ and intraobserver agreement using the “Guidelines for diagnostic thyroid ultrasonography,” of the TSGKSNRHNR in the description and categorization of thyroid nodules. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2010