Interobserver agreement of contrast-enhanced harmonic endoscopic ultrasonography in the evaluation of solid pancreatic lesions

• Type: Another Publication in an International Scientific Journal
• Date: 2015

Authors

Soares, JB (Author) Other; Iglesias Garcia, J (Author) Other; Goncalves, B (Author) Other; Lindkvist, B (Author) Other; Larino Noia, J (Author) Other; Bastos, P (Author) Other; Caetano, AC (Author) Other; Ferreira, A (Author) Other; Pedro Pimentel-Nunes (Author) FMUP; Lopes, L (Author) Other; Moutinho, P (Author) Other; Dominguez Munoz, JE (Author) Other

Journal

Title: Endoscopy International Open

Vol. 3

Pages: E205-E209

ISSN: 2364-3722

Publisher: Georg Thieme Verlag

Indexing

ISI Web of Knowledge - 6 Citations

Other information

Authenticus ID: P-00M-W9T

DOI: 10.1055/s-0034-1391415

Abstract (EN): Background and study aims: Previous reports assessing the reproducibility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) in the evaluation of solid pancreatic lesions (SPLs) involved mainly experienced endosonographers. We aimed to assess the interobserver agreement (IOA) of CH-EUS in the evaluation of SPLs by endoscopists with different levels of experience in EUS and CH-EUS. Participants and methods: A cross-sectional observational multicenter study was designed and included 11 endoscopists who were divided into four groups according to their experience in EUS and CH-EUS: group A (long experience in EUS and CH-EUS); group B (short experience in EUS and CH-EUS); group C (long experience in EUS and no experience in CH-EUS); and group D (no experience in EUS or CH-EUS). The observers independently classified the patterns of 60 CH-EUS video sequences of 60 SPLs after a 20-minute training session. For each group, we calculated the IOA (kappa statistic,.) of CH-EUS and the accuracy of CH-EUS for the diagnosis of pancreatic adenocarcinoma by comparing the pattern of CH-EUS indicative of pancreatic adenocarcinoma (hypo-enhanced contrast pattern) with the final diagnosis. Results: The overall IOA for CH-EUS was fair (kappa = 0.32; 95% CI 0.22-0.41). Group A (kappa = 0.63; 95% CI 0.45-0.85) had the highest IOA, followed by group C (kappa = 0.54; 95% CI 0.39-0.71), group B (kappa = 0.38; 95% CI 0.22-0.55), and group D (kappa = 0.21; 95 % CI 0.07-0.36). The IOA of groups A and C was significantly higher than that of group D. No significant difference was seen between groups A, B, and C or between groups B and D in terms of IOA. Group A (area under the curve under summary receiver operating characteristic [AUROC] = 0.67; 95% CI 0.58-0.75) had the highest accuracy for the diagnosis of pancreatic adenocarcinoma, followed by group C (AUROC = 0.58; 95% CI 0.50-0.65), group B (AUROC = 0.55; 95% CI 0.48-0.63), and group D (AUROC = 0.51; 95% CI 0.43-0.58). The diagnostic accuracy of group A was not significantly different from that of group C, but it was significantly higher than that of groups B and D. No significant difference was seen between groups B, C, and D in terms of diagnostic accuracy. Conclusions: CH-EUS is reproducible in the evaluation of SPLs, even between endoscopists with no or limited experience in EUS and/or CH-EUS. Long experience in EUS is a major contributor to the IOA and diagnostic accuracy of CH-EUS.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5