Soundararajan Raghuraman, Subramanian Pavithra, Gupta Pankaj, Rana Pratyaksha, Chhabra Manika, Singh Shravya, Siddiqui Ruby, Das Chandan, Yadav Thakur D, Gupta Vikas, Kaman Lileswar, Singh Harjeet, Irrinki Santosh, Gupta Parikshaa, Saikia Uma N, Nada Ritambhra, Dutta Usha, Sandhu Manavjit S
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Clin Exp Hepatol. 2024 Jul-Aug;14(4):101393. doi: 10.1016/j.jceh.2024.101393. Epub 2024 Mar 5.
This article aims to evaluate the intrareader and interreader agreement of ultrasound (US) gallbladder reporting and data system (GB-RADS) and validate the risk of malignancy in each GB-RADS category.
This retrospective study comprised consecutive patients with nonacute gallbladder wall thickening who underwent US evaluation between January 2019 and December 2022. Three radiologists independently read the static US images and cine-loops for GB-RADS findings and assigned GB-RADS categories. The intraobserver (static images) and interobserver (static images and cine-loops) agreement was calculated using kappa statistics and Krippendorff's alpha. Another radiologist assigned a consensus GB-RADS category. The percentage of malignancy in each GB-RADS category was calculated.
Static US images of 414 patients (median age, 56 years; 288 women, benign = 45.6% and malignant = 54.4%) and cine-loops of 50 patients were read. There was weak to moderate intrareader agreement for most GB-RADS findings and moderate intrareader agreement for the GB-RADS category for all readers. On static images, the interreader agreement was acceptable for GB-RADS categories. On cine-loops, the interreader agreement for GB-RADS findings and categories was better than static images. The percentage of malignancy was 1.2%, 37%, 71.1%, and 89.1% in GB-RADS 2, 3, 4, and 5 categories.
GB-RADS has moderate intrareader for GB-RADS categories. As originally proposed, the risk of malignancy is negligible in GB-RADS 2 category and highest in GB-RADS 5 category. However, the discriminatory performance of GB-RADS 3 and 4 categories is low. Larger multicenter studies with more readers must assess the reader agreement and validate the GB-RADS systems for wider clinical utilization.
本文旨在评估超声（US）胆囊报告和数据系统（GB-RADS）的阅片者内和阅片者间一致性，并验证每个GB-RADS类别的恶性风险。
这项回顾性研究纳入了2019年1月至2022年12月期间接受超声评估的非急性胆囊壁增厚的连续患者。三名放射科医生独立阅读GB-RADS检查结果的静态超声图像和动态环，并指定GB-RADS类别。使用kappa统计量和Krippendorff's alpha计算观察者内（静态图像）和观察者间（静态图像和动态环）一致性。另一名放射科医生指定了一个共识GB-RADS类别。计算每个GB-RADS类别的恶性百分比。
阅读了414例患者的静态超声图像（中位年龄56岁；288名女性，良性=45.6%，恶性=54.4%）和50例患者的动态环。大多数GB-RADS检查结果的阅片者内一致性为弱至中度，所有阅片者对GB-RADS类别的阅片者内一致性为中度。在静态图像上，GB-RADS类别的阅片者间一致性可接受。在动态环上，GB-RADS检查结果和类别的阅片者间一致性优于静态图像。GB-RADS 2、3、4和5类别的恶性百分比分别为1.2%、37%、71.1%和89.1%。
GB-RADS对GB-RADS类别具有中度阅片者内一致性。如最初所提出的，GB-RADS 2类别的恶性风险可忽略不计，GB-RADS 5类别的恶性风险最高。然而，GB-RADS 3和4类别的鉴别性能较低。必须进行更大规模的多中心研究，纳入更多阅片者，以评估阅片者一致性并验证GB-RADS系统，以便更广泛地应用于临床。
