title: Inter-observer agreement on the assessment of relative liver lesion signal intensity on hepatobiliary phase imaging with gadoxetate (Gd-EOB-DTPA).
abstract: OBJECTIVE
  The purpose of the study was to assess the inter-observer agreement on the qualitative and quantitative evaluation of relative signal intensity of liver lesions on delayed hepatobiliary phase (HBP) MRI with gadoxetate (Gd-EOB-DTPA).
  
  
  METHODS
  105 patients with liver lesions, who had delayed HPB MRI using gadoxetate were reviewed retrospectively. For each patient, four readers (two fellows in training and two attending radiologists) qualitatively assessed the relative SI of the largest representative lesion on a five point scale, and quantitatively measured the relative SI of the lesion to adjacent liver parenchyma using region of interests (ROI). Intra-class correlation (ICC) and kappa statistics with quadratic weights (k) analysis, and maximally selected rank statistic were performed.
  
  
  RESULTS
  Substantial agreement between fellows (k = 0.719; ICC = 0.705) and almost perfect agreement between attending radiologists (k = 0.853; ICC = 0.849) were found for both qualitative and quantitative assessments of relative SI on delayed HPB imaging. A cut-off ratio to differentiate between hypointense and iso- to hyperintense lesions by ROI was calculated to be 0.90.
  
  
  CONCLUSIONS
  Inter-observer agreement of liver lesion relative SI on delayed HBP imaging is high and may improve with radiologist experience. A cut-off ratio of relative SI at 0.90 may be useful to quantitatively distinguish hypointense from iso- to hyperintense liver lesions.
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-278D, New York, NY, 10065, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Ngu
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-278D, New York, NY, 10065, USA.
authors.forename: Lizza
authors.initials: L
authors.lastname: Lebron-Zapata
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-278D, New York, NY, 10065, USA.|Department of Radiology, New York Presbyterian Hospital-Weill Cornell, New York, NY, USA.
authors.forename: Christy
authors.initials: C
authors.lastname: Pomeranz
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-278D, New York, NY, 10065, USA.
authors.forename: Seth
authors.initials: S
authors.lastname: Katz
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-278D, New York, NY, 10065, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Gerst
authors.affiliation: Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Junting
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Chaya
authors.initials: C
authors.lastname: Moskowitz
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-278D, New York, NY, 10065, USA. dok@mskcc.org.
authors.forename: Richard K G
authors.initials: RK
authors.lastname: Do
mesh_terms: D001706:Biopsy; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Eovist; Gadoxetic; Interreader agreement; MRI; Primovist
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