1. Intraobserver and Interobserver Agreement in the Evaluation of Tumor Vascularization With Computed Tomography Perfusion in Cirrhotic Patients With Hepatocellular Carcinoma
- Author
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Davide Fior, Pietro Andrea Bonaffini, Alessandra Casiraghi, Davide Ippolito, Cammillo Talei Franzesi, Sandro Sironi, Ippolito, D, Casiraghi, A, TALEI FRANZESI, C, Bonaffini, P, Fior, D, and Sironi, S
- Subjects
Liver Cirrhosis ,Male ,observer agreement ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Computed tomography perfusion ,Intraclass correlation ,Radiofrequency ablation ,Liver Cirrhosi ,Reproducibility of Result ,Blood volume ,Perfusion scanning ,Tumor vascularization ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Multidetector Computed Tomography ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Observer Variation ,Neovascularization, Pathologic ,business.industry ,Medicine (all) ,Liver Neoplasms ,Reproducibility of Results ,Arterial perfusion ,computed tomography ,hepatocellular carcinoma ,Middle Aged ,medicine.disease ,Liver ,Liver Neoplasm ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,CT perfusion ,Female ,Radiology ,business ,Human - Abstract
Objectives To evaluate intrareader and inter-reader agreement in CT perfusion (Perf) measurements in cirrhotic patients with hepatocellular carcinoma (HCC) lesions. Methods Sixteen patients with HCC (9 untreated, 5 recurrence/residual disease after transarterial chemoembolization, and 2 after radiofrequency ablation treatment) underwent standard CT examination and a Perf study; a quantitative map of arterial and portal Perf by means of a color scale was generated. With dedicated Perf software, the following parameters were calculated on untreated and treated HCC lesions and on cirrhotic parenchyma: hepatic Perf, tissue blood volume, hepatic perfusion index, arterial perfusion, and time to peak. Intraobserver and interobserver agreements were assessed for 2 readers with Bland-Altman plots, intraclass correlation coefficients (ICCs), coefficients of variation, and repeatability. Results In HCC lesions, agreement analysis demonstrated higher intra-agreement values in comparison with interagreement (range of ICC values, 0.26-0.59 between readers and 0.67-0.94 between readings). Lower interagreement was found for treated HCC lesions in comparison with untreated lesions (range of ICC values, respectively, 0.12-0.54 and 0.31-0.89). Conclusions For all Perf parameters intra-agreement was higher than interagreement, even though a relatively wide range of 95% limits of agreement was found in both cases.
- Published
- 2016