Contrast enhanced ultrasound diagnosis of complex cystic renal mass: Interobserver variability based on different Bosniak classification systems

WFUMB Ultrasound Open Pub Date : 2023-09-07 DOI:10.1016/j.wfumbo.2023.100007

Pei Sun , Qing Lu , Luxia Jing , Cuixian Li , Jiexian Wen , Cong Li , Jingjing Wang , Hongli Cao , Beijian Huang

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Abstract

The diagnostic value of Bosniak classification based on contrast enhanced ultrasound (CEUS) on complex cystic renal mass (CRM) was compared among different observers. From 2012 to 2022, 212 complex CRMs, confirmed by pathology or at least 1-year imaging follow-up, were enrolled. The CEUS images of CRM were retrospectively analyzed by two reviewers with different experience in kidney CEUS examination, and each lesion was given the categorizations according the Bosniak ver. 2015 and ver. 2019, respectively. There was good inter-observer agreement (k = 0.689; p < 0.05) for Bosniak ver. 2019. With Bosniak ver. 2019, senior and junior reviewer correctly classified 44 (83.02%), 40 (75.47%) benign lesions as low grade (Ⅰ ∼ ⅡF), and 94 (94.95%), 80 (80.81%) malignant tumors as high grade (Ⅲ or Ⅳ), respectively. Meanwhile, the combination of Bosniak 2019 and senior reviewer demonstrated the highest area under the receiver operating characteristic curve (Az: 0.875, all p < 0.05) than other groups, with the highest specificity (81.10%) and sensitivity (93.90%) among all the groups (95% CI, 0.807–0.943; p < 0.05), respectively. Overall, the senior reviewer combined with Bosniak ver. 2019 was the best choice for the diagnosis of complex CRM.

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对比增强超声诊断复杂囊性肾肿块:基于不同Bosniak分类系统的观察者间差异

比较不同观察者之间基于对比增强超声（CEUS）的Bosniak分类对复杂囊性肾肿块（CRM）的诊断价值。从2012年到2022年，共有212例经病理学或至少一年的影像学随访证实的复杂CRM入选。两位具有不同肾脏CEUS检查经验的评审员对CRM的CEUS图像进行了回顾性分析，并分别根据Bosniak 2015年版和2019年版对每个病变进行了分类。2019年波什尼亚克的观察者之间存在良好的一致性（k=0.689；p<；0.05）。Bosniak ver.2019，高级和初级评审员分别正确地将44个（83.02%）、40个（75.47%）良性病变分为低级别（Ⅰ～ⅡF），94个（94.95%）、80个（80.81%）恶性肿瘤分为高级别（Ⅲ或Ⅳ）。同时，与其他组相比，Bosniak 2019和高级评审员的组合在受试者操作特征曲线下的面积最高（Az:0.875，均p<；0.05），在所有组中具有最高的特异性（81.10%）和敏感性（93.90%）（95%CI，0.807–0.943；p<；05）。总体而言，高级评审员结合Bosniak ver.2019是诊断复杂CRM的最佳选择。

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WFUMB Ultrasound Open

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