Focal liver lesions: interobserver and intraobserver agreement of three-dimensional contrast-enhanced ultrasound-assisted volume measurements

Abstract

This study was conducted to assess the interobserver and intraobserver agreement of three-dimensional contrast-enhanced ultrasound (3D-CEUS) volume calculations of focal liver lesions (FLLs). Methods: Thirty-nine patients (15 men and 24 women; mean age, 55.4 years) with 39 FLLs (mean size, 3.1±1.8 cm; size range, 1 to 8 cm) prospectively underwent 3D-CEUS. Four readers calculated the volume of each lesion in an independent and blinded fashion in two separate sessions by means of a semi-automatic, commercially available proprietary software. The differences in lesion volumes (cm 3) among sessions and readers were assessed using the Mann-Whitney U test and the Kruskal-Wallis test. Bland-Altman analysis was also performed. Intraclass correlation coefficients (ICCs) with 95% confidence intervals (95% CIs) were calculated. The statistical significance level was set at P<0.05. Results: Among readers, there were no statistically significant differences in the first (P=0.953) and second (P=0.592) reading sessions for volume calculations of the 39 FLLs, with almost perfect inter-reader agreement (ICC values of 0.996; 95% CI, 0.992 to 0.998 and 0.994; 95% CI, 0.990 to 0.997, respectively). For each of the four readers, there were no significant differences in volume calculations between the two sessions (P=0.503-0.927), and the intrareader agreement was almost perfect for each reader (R1:

New frontiers in liver ultrasound: From mono to multi parametricity

“…More recent US advances allow a three-dimensional assessment of tumor volume and shape, promising further refinement of CEUS role in planning, treatment and tumor response assessment of HCC treated by means of loco-regional therapies (Figure 6 )[ 3 ].…”

“…In a study on 83 FLLs, when compared to 2D US, 3D CEUS revealed more details of the boundary and feeding vessels of the mass, as well as distorted features of supply vessels of HCC[ 51 ]. 3D-CEUS may also provide volume calculations with almost perfect intrareader agreement which can be used in preoperative planning for loco-regional treatment of focal liver tumors and for effective tumor response assessment after treatment (Figure 6 )[ 3 ].…”

“…In particular liver US has progressively achieved an unprecedented B-mode image quality, being even capable of processing and displaying “harmonic frequencies” which were previously considered “noise” and simply cut off[ 2 ]. US is no more a merely bi-dimensional technique but it is also possible to acquire and display in real time entire liver volumes, which can be in turn post-processed for volume calculation or rendering[ 3 ].…”