Interobserver variability in the interpretation of unenhanced helical CT for the diagnosis of ureteral stone disease.
Publication/Presentation Date
1-1-1998
Abstract
PURPOSE: The purpose of this study was to analyze interobserver agreement in the interpretation of unenhanced helical CT (UHCT) for the evaluation of ureteral stone disease and obstruction.
METHOD: One hundred three UHCT examinations were independently and retrospectively reviewed by five readers including attending radiologists, a radiology resident, and an attending urologist. Examinations were interpreted as positive, negative, or indeterminate for ureteral stone disease and obstruction. The Cohen kappa test was used to measure interobserver agreement. The accuracy of the readers was also assessed.
RESULTS: The kappa value ranged from 0.67 to 0.71 among the three attending radiologists and from 0.65 to 0.67 among the radiology attending physicians and radiology resident. Although the urologist tended to agree less well with the other readers (kappa range: 0.33-0.46), there was no statistically significant difference (p < 0.05) in the accuracy among all five readers. The percentage of cases interpreted as indeterminate ranged from 8 to 25% and almost invariably involved difficulty distinguishing phleboliths from minimally obstructing distal ureteral calculi. The percentage of UHCT scans correctly interpreted as positive and correctly interpreted as negative ranged from 73% (n = 27) to 86% (n = 32) and 63% (n = 22) to 86% (n = 30), respectively.
CONCLUSION: Interobserver agreement was very good among the radiology attending physicians and resident and moderate with the urologist. The examination is an accurate technique in the evaluation of ureteral stone disease, although limitations exist, particularly in the diagnosis of minimally obstructing distal ureteral calculi.
Volume
22
Issue
5
First Page
732
Last Page
737
ISSN
0363-8715
Published In/Presented At
Freed, K. S., Paulson, E. K., Frederick, M. G., Preminger, G. M., Shusterman, D. J., Keogan, M. T., Vieweg, J., Smith, R. H., Nelson, R. C., Delong, D. M., & Leder, R. A. (1998). Interobserver variability in the interpretation of unenhanced helical CT for the diagnosis of ureteral stone disease. Journal of computer assisted tomography, 22(5), 732–737. https://doi.org/10.1097/00004728-199809000-00013
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
9754108
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article