Seppala Nicholas, Kielar Ania, Dabreo Dominique, Duigenan Shauna
The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, ON, K1S 8L6, Canada,
Abdom Imaging. 2014 Dec;39(6):1267-73. doi: 10.1007/s00261-014-0162-5.
To evaluate inter-observer agreement of MRI features and classification of cystic renal masses among radiologist and radiology trainees.
Four readers (two radiologists and two radiology trainees) retrospectively reviewed 100 cystic renal lesions on gadolinium enhanced MRI and assigned each a Bosniak classification (1, 2, 2F, 3, and 4). Lesions were also assessed on their individual features including size, presence of nodules, septations, and enhancement. Readers ranked their level of confidence regarding Bosniak classifications. Inter-observer variability of lesion classification and features was evaluated between raters at both radiologist and radiology trainee levels as well as the level of agreement of all four readers using weighted Kappa and intraclass correlation coefficient (ICC).
One hundred cystic renal lesions were evaluated. There was moderate and substantial classification agreement between trainees and radiologists (ICC 0.59 and 0.63, respectively). There was substantial classification agreement among all four readers (0.66) with the lowest level of agreement for Bosniak 2F lesions (ICC 0.14). There was moderate-substantial agreement for the presence of nodular component, septations, and enhancement. Staff demonstrated highest agreement when assessing for nodular components (0.73). Agreement for the presence of enhancement was lowest (0.37 and 0.42 for radiologists and trainees, respectively). Reported confidence was higher among radiologists compared with trainees.
There is substantial overall inter-observer agreement in the MRI classification of cystic renal lesions. Confidence increases as rater experience increases.
评估放射科医生和放射科实习医生之间关于肾囊性肿块的MRI特征及分类的观察者间一致性。
四位读者（两位放射科医生和两位放射科实习医生）回顾性分析了100例钆增强MRI上的肾囊性病变，并对每个病变进行博斯尼亚克分类（1、2、2F、3和4类）。还对病变的个体特征进行评估，包括大小、结节、分隔和强化情况。读者对其博斯尼亚克分类的信心程度进行排序。在放射科医生和放射科实习医生层面评估评分者之间病变分类和特征的观察者间变异性，以及使用加权卡帕和组内相关系数（ICC）评估所有四位读者的一致性水平。
共评估了100例肾囊性病变。实习医生和放射科医生之间存在中度和高度的分类一致性（ICC分别为0.59和0.63）。所有四位读者之间存在高度的分类一致性（0.66），其中博斯尼亚克2F类病变的一致性水平最低（ICC为0.14）。对于结节成分、分隔和强化的存在，存在中度至高度的一致性。在评估结节成分时，工作人员的一致性最高（0.73）。强化存在的一致性最低（放射科医生和实习医生分别为0.37和0.42）。放射科医生报告的信心高于实习医生。
肾囊性病变的MRI分类在观察者间总体上存在高度一致性。随着评分者经验的增加，信心增强。
