Accuracy of diagnostic ultrasound for detection of cystic lesions: determination using receiver operating characteristic curve analysis of findings in phantom studies.

Anechoic, spherical cystic lesions are important findings on ultrasound examination. In polycystic renal disease of cats, they may be the only ultrasonographic sign of disease. This study assesses the accuracy of ultrasound, as used in a veterinary setting, for the detection of cysts. Using a spherical lesion ultrasound imaging phantom and 7.5- to 8-MHz linear array transducers, images of cysts of 2- and 4-mm diameter were created at various imaging depths from 0 to 6 cm. These were digitized and given to a panel of readers for interpretation. Area under receiver operating characteristic curves were used to evaluate test accuracy. It was shown that test accuracy was different at different imaging depths and differed with machines of differing price category. It is suggested that when setting standards for quality control in ultrasound, criteria used might be better related to imaging outcome studies rather than to aspects of machine specification.