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New endoscopic ultrasonography criteria for malignant lymphadenopathy based on inter-rater agreement

Authors :
Yoshitsugu Yoshida
Akane Yamabe
Atsushi Irisawa
Shogo Yamamoto
Ai Sato
Goro Shibukawa
Ryo Igarashi
Yoko Abe
Noriyuki Arakawa
Takumi Maki
Yusuke Takasaki
Tsunehiko Ikeda
Source :
PLoS ONE, PLoS ONE, Vol 14, Iss 2, p e0212427 (2019)
Publication Year :
2019
Publisher :
Public Library of Science (PLoS), 2019.

Abstract

Background and aimsVarious studies have been previously conducted on the diagnosis of lymphadenopathy as benign or malignant, but the results vary. These studies did not describe the inter-rater agreement on the EUS features of lymphadenopathy. In this study, we evaluate the inter-rater agreement on EUS features and propose EUS diagnostic norms for lymphadenopathy based on inter-rater agreement.MethodA total of 68 lymph nodes subjected to EUS-fine needle aspiration (FNA) were reviewed by five endoscopic experts. The EUS features evaluated lymph node size, shape, border, margin, echogenicity, homogeneity, and the hilum of the lymph node. Inter-rater agreement (multi-rater kappa statics) was performed. We established new criteria using results with a high degree of inter-rater agreement from EUS features and compared them with the former criteria.ResultThere was a moderate agreement on shape, kappa (K) = 0.44 (95% confidence interval [CI]: 0.34-0.54), and fair agreement on echogenicity, homogeneity, border, and hilum of the lymph node, K (95% CI) = 0.33 (0.17-0.38), 0.34 (0.26-0.35), 0.22 (0.21-0.31), and 0.22 (0.11-0.26), respectively. This resulted in the establishment of new EUS diagnostic criteria using shape, long axis > 20 mm and short axis > 10 mm. New criteria were superior to old criteria (area under the curve 0.82 vs 0.52, P < 0.001).ConclusionEUS diagnostic criteria for lymphadenopathy based on inter-rater agreement were more accurate than old criteria. This result will be useful for the diagnosis of lymphadenopathy.

Details

ISSN :
19326203
Volume :
14
Database :
OpenAIRE
Journal :
PLOS ONE
Accession number :
edsair.doi.dedup.....fe8262446bb0e015a2532d0753dc5032