title: Inter- and intraobserver agreement in detection of testicular microlithiasis with ultrasonography.
abstract: BACKGROUND
  Ultrasonography of the testis is a well-established diagnostic tool in detection of testicular microlithiasis (TML). Operator-dependent diagnostic variation related to skill, knowledge, and operator consistency are factors that influence detection of TML.
  
  
  OBJECTIVE
  To determine inter- and intraobserver agreement for detection of TML using ultrasonography for a group of physicians with no or limited experience compared to a group of experience senior radiologists.
  
  
  METHODS
  Between May and September 2014 a total of six observers evaluated 34 patients scrotal ultrasonography recorded from September to December 2013. The observers were blinded to patient history and previous ultrasonography. Three of the observers had no or limited experience with detection of TML, and three of the observers had more than 15 years of experience. Each observer reviewed all the scrotal ultrasonography recordings twice with a time interval of 3 months.
  
  
  RESULTS
  The inter-observer agreement showed substantial agreement and up to almost perfect agreement (κ = 0.86). Both the experienced and less experienced observers had a higher agreement in detecting and grading TML in their second reading.
  
  
  CONCLUSIONS
  The ultrasonography grading system of TML in this study showed to be reproducible, with an inter- and intraobserver agreement ranging between substantial agreement and up to almost perfect agreement with many years of experience not necessarily being essential.
authors.affiliation: Department of Radiology, Lillebaelt Hospital, Vejle, Denmark Urological Research Center, Department of Urology, Lillebaelt Hospital, Fredericia, Denmark Institute of Regional Health Research, University of Southern Denmark, Denmark Malene.Roland.Vils.Pedersen@rsyd.dk.
authors.forename: Malene Roland
authors.initials: MR
authors.lastname: Pedersen
authors.affiliation: Department of Radiology, Aarhus University Hospital, Skejby, Denmark CECLUS, Center of Clinical Ultrasound, Aarhus University, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Graumann
authors.affiliation: Department of Radiology, Aarhus University Hospital, Skejby, Denmark CECLUS, Center of Clinical Ultrasound, Aarhus University, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Hørlyck
authors.affiliation: Department of Radiology, Lillebaelt Hospital, Vejle, Denmark.
authors.forename: Louise Aarup
authors.initials: LA
authors.lastname: Duus
authors.affiliation: Department of Radiology, Lillebaelt Hospital, Vejle, Denmark.
authors.forename: Mette Marie B
authors.initials: MM
authors.lastname: Jørgensen
authors.affiliation: Department of Radiology, Lillebaelt Hospital, Vejle, Denmark.
authors.forename: Chris
authors.initials: C
authors.lastname: Vagn-Hansen
authors.affiliation: Institute of Regional Health Research, University of Southern Denmark, Denmark.
authors.forename: René
authors.initials: R
authors.lastname: Holst
authors.affiliation: Department of Radiology, Lillebaelt Hospital, Vejle, Denmark Institute of Regional Health Research, University of Southern Denmark, Denmark.
authors.forename: Søren Rafael
authors.initials: SR
authors.lastname: Rafaelsen
mesh_terms: D000328:Adult; D000368:Aged; D002137:Calculi / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D013733:Testicular Diseases / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*
keywords: Ultrasound; calculi; observer performance; observer variation; testicular diseases; testicular microlithiasis; testis