title: Intra-/Interobserver Agreement of Enhancement Pattern for Pancreatic Head Lesions Using Contrast-Enhanced Ultrasound: According to EFSUMB Guidelines.
abstract: OBJECTIVE
  To evaluate the intra-/interobserver agreement of the visual interpretation of contrast-enhanced ultrasound (CEUS) of pancreatic head lesions and its concordance with the histological test results.
  
  
  METHODS
  Two observers (A + B) evaluated by simple visual interpretation 40 consecutive CEUS examinations of pancreatic head lesions and one of the observers evaluated the examinations twice (A1 + A2). The examinations were evaluated according to the criteria outlined in EFSUMB guidelines. The two experienced observers were blinded to histological evidence and clinical information of tumor type and to each other's results.
  
  
  RESULTS
  The kappa value for the intraobserver evaluation between observer A1 and A2 was 0.89, equating to almost perfect agreement. The kappa value for the interobserver evaluation between observer A1 and B was 0.76 and between observer A2 and B it was 0.75, both equating to substantial agreement. Evaluation of the visual interpretation compared to the histological test result showed a positive predictive value for A1, A2 and B versus biopsy of 97%, 94% and 90% respectively and an accuracy of 83%, 88% and 73% respectively.
  
  
  CONCLUSIONS
  Visual interpretation for assessment of contrast enhancement of pancreatic head lesions seemed to be an accurate method with reproducible results and good concordance with the histological test results.
authors: Department of Radiology, Section of Ultrasound X4123, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK 2100, Denmark. hannesonder@dadlnet.dk.
authors: Hanne Sønder
authors: HS
authors: Grossjohann
authors: Department of Radiology, Section of Ultrasound X4123, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK 2100, Denmark. caroline.ewertsen@dadlnet.dk.
authors: Caroline
authors: C
authors: Ewertsen
authors: Department of Radiology, Section of Ultrasound X4123, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK 2100, Denmark. larsbo.svendsen@dadlnet.dk.
authors: Lars Bo
authors: LB
authors: Svendsen
authors: Department of Radiology, Section of Ultrasound X4123, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK 2100, Denmark. mbn@dadlnet.dk.
authors: Michael Bachmann
authors: MB
authors: Nielsen
keywords: contrast-enhanced ultrasound (CEUS); intra-/interobserver agreement; pancreatic head lesions