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首页> 外文期刊>Endoscopy International Open >Interobserver agreement of contrast-enhanced harmonic endoscopic ultrasonography in the evaluation of solid pancreatic lesions
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Interobserver agreement of contrast-enhanced harmonic endoscopic ultrasonography in the evaluation of solid pancreatic lesions

机译：超声造影对比超声内镜在实性胰腺病变评估中的观察者一致性

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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, κ) 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 (κ?=?0.32; 95?%CI 0.22?–?0.41). Group A (κ?=?0.63; 95?%CI 0.45?–?0.85) had the highest IOA, followed by group C (κ?=?0.54; 95?%CI 0.39?–?0.71), group B (κ?=?0.38; 95?%CI 0.22?–?0.55), and group D (κ?=?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.
机译：背景和研究目的：先前的报告评估了超声造影内镜超声造影（CH-EUS）在评价主要由经验丰富的超声内镜检查员所涉及的实体胰腺病变（SPL）中的可重复性。我们旨在评估具有不同EUS和CH-EUS经验水平的内镜医师对CH-EUS的观察者间协议（IOA）进行评估。参与者和方法：设计了一项横断面观察性多中心研究，纳入了11名内镜医师，根据其在EUS和CH-EUS方面的经验分为四组：A组（在EUS和CH-EUS方面的长期经验）; B组（在EUS和CH-EUS方面经验不足）; C组（在EUS中有长期经验，而在CH-EUS中没有经验）; D组（没有EUS或CH-EUS经验）。在经过20分钟的训练后，观察者对60个SPL的60个CH-EUS视频序列的模式进行了独立分类。对于每个组，我们通过比较指示胰腺腺癌的CH-EUS模式（低增强对比模式），计算CH-EUS的IOA（k统计值，κ）和CH-EUS诊断胰腺癌的准确性最终诊断。结果：CH-EUS的总体IOA相当（κ= 0.32; 95％CI 0.22〜0.41）。 A组（κ？=？0.63; 95 %% CI 0.45？–？0.85）的IOA最高，其次是C组（κ？=？0.54; 95 %% CI 0.39？–？0.71），B组（κ α＝ 0.38; 95％CI为0.22〜0.55）和D组（κ＝ 0.21; 95％CI为0.07〜0.36）。 A和C组的IOA显着高于D组。就IOA而言，A，B和C组之间或B和D组之间没有显着差异。 A组（总结接受者操作特征[AUROC] = 0.67; 95 %% CI 0.58？-？0.75）下的曲线区域对胰腺腺癌的诊断准确性最高，其次是C组（AUROC？=？65）。 0.58; 95 %% CI 0.50？-？0.65），B组（AUROC？=？0.55; 95？％CI 0.48？-？0.63）和D组（AUROC？=？0.51; 95 %% CI 0.43？- 0.58）。 A组的诊断准确性与C组没有显着差异，但显着高于B和D组。B，C和D组之间在诊断准确性上没有显着差异。结论：CH-EUS在SPL的评估中具有可重现性，即使在没有或很少有EUS和/或CH-EUS经验的内镜医师之间也是如此。EUS的丰富经验是CH-EUS的IOA和诊断准确性的主要因素。

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