title: Interobserver agreement in contrast harmonic endoscopic ultrasound.
abstract: OBJECTIVE
  Contrast harmonic endoscopic ultrasound (CH-EUS) was recently introduced to clinical practice; its reproducibility among endosonographers is unknown. Our aim was to assess the interobserver agreement (IA) in CH-EUS.
  
  
  METHODS
  Fifteen endosonographers (eight experienced and seven non-experienced) from 11 Italian EUS centers evaluated 80 video-cases (40 solid pancreatic lesions, 20 pancreatic cystic lesions and 20 submucosal lesions) of CH-EUS, according to the degree of enhancement, the pattern of distribution and the washout of the contrast agent. IA within each group and between the two groups of observers was assessed with the Fleiss kappa statistic.
  
  
  RESULTS
  Overall IA was moderate for the uptake and fair for the pattern of distribution and the washout. In solid pancreatic lesions, IA was moderate for the uptake and fair for the pattern and the washout. In cystic pancreatic lesions, IA was uniformly moderate for the assessment of uptake, slight for the pattern and fair for the washout. In submucosal tumors, IA was substantial for the uptake, slight for the pattern and fair for the washout. Non-experienced endosonographers demonstrated, in most cases, comparable IA with the experienced ones.
  
  
  CONCLUSIONS
  Interobserver agreement among endosonographers for CH EUS was satisfactory. In particular, overall IA varied from slight to substantial, being fair in the majority of cases. Inherent structural features of the lesions, as well as technical differences between the variables assessed, could have accounted for the fluctuation of the results. Outcomes of IA were reproducible between experienced and non-experienced endosonographers.
authors.affiliation: Department of Clinical Medicine, GI Unit, University of Bologna/Imola Hospital, Italy Gastroenterology Unit, Bellaria Hospital, Bologna, Italy. pietro.fusaroli@unibo.it
authors.forename: Pietro
authors.initials: P
authors.lastname: Fusaroli
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kypraios
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Mancino
authors.forename: Alessia
authors.initials: A
authors.lastname: Spada
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Benini
authors.forename: Marco
authors.initials: M
authors.lastname: Bianchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Bocus
authors.forename: Claudio
authors.initials: C
authors.lastname: De Angelis
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
authors.forename: Antonino
authors.initials: A
authors.lastname: Grillo
authors.forename: Marco
authors.initials: M
authors.lastname: Marzioni
authors.forename: Dario
authors.initials: D
authors.lastname: Reggio
authors.forename: Thomas
authors.initials: T
authors.lastname: Togliani
authors.forename: Stefano
authors.initials: S
authors.lastname: Zanarini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Caletti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003287:Contrast Media; D019160:Endosonography / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D055815:Young Adult
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride