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Interobserver variability and diagnostic performance in US assessment of thyroid nodule according to size

 S. J. Park  ;  S. H. Park  ;  Y. J. Choi  ;  D. W. Kim  ;  E. J. Son  ;  H. S. Lee  ;  J. H. Yoon  ;  E.-K. Kim  ;  H. J. Moon  ;  J. Y. Kwak 
 ULTRASCHALL IN DER MEDIZIN, Vol.33(7) : 186-190, 2012 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland/diagnostic imaging ; Thyroid Gland/pathology ; Thyroid Gland/surgery ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology ; Thyroid Nodule/surgery ; Tumor Burden ; Ultrasonography, Interventional ; Young Adult
head/neck ; tumor ; ultrasound
PURPOSE: To evaluate the interobserver variability for US assessments of thyroid nodules and analyze the diagnostic performances of US assessments in thyroid nodules according to nodule size. MATERIALS AND METHODS: This was an IRB-approved retrospective study with waiver of informed consent. A total of 400 surgically-confirmed thyroid nodules were included. Nodules were divided into 4 groups by size; group 1 (nodule size < 5 mm), group 2 (5 mm ≤ nodule size < 10 mm), group 3 (10 mm ≤ nodule size < 20 mm), and group 4 (nodule size ≥ 20 mm). Three experienced (7 - 10 years) radiologists retrospectively reviewed the US images. Agreement of each US descriptor and final US assessment, and diagnostic performances were calculated in each group and compared. RESULTS: Composition represented substantial or good agreement (k = 0.719 - 0.89). Margin showed the lowest agreement (k = 0.322 - 0.365). Individual kappa values for final assessment according to nodule size were as follows: group 1 (k = 0.674), group 2 (k = 0.596), group 3 (k = 0.674), and group 4 (k = 0.673). Specificity, PPV, and accuracy were significantly different among the groups with different size (p value < 0.05) and lowest in group 1. NPV, specificity, PPV and accuracy except PPV of observer 3 increased with nodule size (p < 0.05). CONCLUSION: Interobserver agreements were relatively good (k = 0.637) in final US assessment regardless of nodule size in experienced radiologists. High false-positive rate was observed in US assessment in nodules less than 5 mm in maximum diameter.
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1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Park, So Hee(박소희)
Park, Suk Jin(박숙진)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
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