title: Visualization of liver lesions in standardized video-documented ultrasonography - inter-observer agreement and effect of contrast injection.
abstract: The AIM of this study was to evaluate the inter-observer agreement and effect of contrast injection on the visibility of liver lesions by radiologists reviewing ultrasound examinations acquired by a radiographer using a standardized examination protocol.
  
  
  METHODS
  A retrospective review was conducted by two radiologists, independently of each other, of 115 ultrasound examinations of the liver with standardized examination protocols between January 2008 and December 2012. All patients included in the study had undergone surgery for colorectal cancer. Patients attending the two-year follow-up were included.
  
  
  RESULTS
  Focal findings, the most common of which were cysts, were seen in 42-43 out of the 115 patients before intravenous contrast and in 46-47 patients after intravenous contrast (p=0.012). The inter-observer agreement for focal findings was 86.1% before contrast, and 90.4% after contrast (n.s.), and the corresponding kappa values were 0.72 and 0.84, respectively.
  
  
  CONCLUSIONS
  A good inter-observer agreement between two radiologists reviewing ultrasound examinations (standardized ultrasound cine-loop method acquired by a radiographer) after surgery for colorectal cancer was obtained. Injection of contrast medium increased the visibility of liver lesions.
authors.affiliation: Department of Radiology and Department of Medical and Health Sciences; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden. carina.stenman@liu.se.
authors.forename: Carina
authors.initials: C
authors.lastname: Stenman
authors.affiliation: Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Robert
authors.initials: R
authors.lastname: Glavas
authors.affiliation: Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Joachim
authors.initials: J
authors.lastname: Davidsson
authors.affiliation: Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Knutsson
authors.affiliation: Department of Radiology and Department of Medical and Health Sciences; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
authors.forename: Örjan
authors.initials: Ö
authors.lastname: Smedby
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007275:Injections, Intravenous; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical; D015588:Observer Variation; D010743:Phospholipids / Q000008:administration & dosage*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013548:Sweden; D014463:Ultrasonography / Q000379:methods* / Q000592:standards; D014741:Video Recording / Q000379:methods* / Q000592:standards
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride