title: Radiographer-acquired and radiologist-reviewed ultrasound examination--agreement with radiologist's bedside evaluation.
abstract: BACKGROUND
  Growing demand for ultrasound examinations and higher quality requirements motivate searching for routines combining the diagnostic accuracy of radiologist-performed examinations with the economical advantages of sonographer-performed examinations. One possible approach is to use strictly standardized acquisition and documentation schemes that give the radiologist access to all relevant information after the examination.
  
  
  OBJECTIVE
  To compare a recently introduced routine, combining acquisition by a radiographer, documentation as standardized cine-loops, and review by a radiologist ('standardized method'), with the formerly used routine where the diagnosis is made bedside by the radiologist ('traditional method').
  
  
  METHODS
  In 64 policlinic patients, the kidneys (n=27) or the gallbladder (n=37) were examined with both the standardized and the traditional method. The radiologists' findings of hydronephrosis, tumors, cysts, echogenicity changes, and cortical thickness (in the kidneys), and wall thickness, concrements, and polyps (in the gallbladder) were compared between the methods with respect to agreement (proportion of agreement and kappa coefficient) as well as systematic differences (McNemar's test).
  
  
  RESULTS
  The findings at the gallbladder examination showed a median agreement of 97% (86-100%; kappa=0.64-1.00), and those at the kidney examination, an agreement of 90% (78-100%; kappa=0.69-1.00). There were no significant systematic differences between the methods.
  
  
  CONCLUSIONS
  The satisfactory agreement in this preliminary study indicates that the new workflow with ultrasound examinations performed by a radiographer and analyzed off-line by a radiologist is promising, and motivates further studies.
authors.affiliation: Division of Radiological Sciences, Radiology, IMH, Linköping University and Linköping University Hospital, Linköping, Sweden. carina.stenman@liu.se
authors.forename: Carina
authors.initials: C
authors.lastname: Stenman
authors.forename: Lars
authors.initials: L
authors.lastname: Thorelius
authors.forename: Anders
authors.initials: A
authors.lastname: Knutsson
authors.forename: Örjan
authors.initials: Ö
authors.lastname: Smedby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D011871:Radiology / Q000592:standards*; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000592:standards*; D055815:Young Adult