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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Interobserver agreement for contrast-enhanced ultrasound of liver imaging reporting and data system: A systematic review and meta-analysis
Jun Li, Ming Chen, Zi-Jing Wang, Shu-Gang Li, Meng Jiang, Long Shi, Chun-Li Cao, Tian Sang, Xin-Wu Cui, Christoph F Dietrich
Jun Li, Ming Chen, Zi-Jing Wang, Chun-Li Cao, Tian Sang, Department of Medical Ultrasound, The First Affiliated Hospital of Medical College, Shihezi University, Shihezi 832008, Xinjiang Uygur Autonomous Region, China
Shu-Gang Li, Department of Child, Adolescent Health and Maternal Health, School of Public Health, Capital Medical University, Beijing 100069, Beijing, China
Meng Jiang, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Long Shi, Department of Medical Ultrasound, The Second People's Hospital of Jiangmen, Jingmen 448000, Hubei Province, China
Xin-Wu Cui, Department of Medical Ultrasound, Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Christoph F Dietrich, Department of Internal Medicine, Hirslanden Clinic, Berne 27804, Switzerland
Author contributions: Li J and Chen M contributed equally to this article; Li J, Cui XW, Shi L, and Dietrich CF designed the research; Li J and Chen M performed the research; Jiang M and Sang T contributed to analytic tools; Cao CL and Li SG analyzed data; Chen M and Wang ZJ wrote the paper; Shi L, Cui XW, and Dietrich CF revised the article and approved the final version.
Supported by Health Commission of Hubei Province, China No. WJ2019M077 and No. WJ2019H227; Natural Science Foundation of Hubei Province, China No. 2019CFB286; and Science and Technology Bureau of Shihezi, China No. 2019ZH11.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other co-authors who contributed their efforts in this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xin-Wu Cui, MD, PhD, Professor, Department of Medical Ultrasound, Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. cuixinwu@live.cn
Received: April 29, 2020
Peer-review started: April 29, 2020
First decision: July 29, 2020
Revised: August 11, 2020
Accepted: September 29, 2020
Article in press: September 29, 2020
Published online: November 26, 2020
Processing time: 210 Days and 0.5 Hours
ARTICLE HIGHLIGHTS
Research background
From the results of previous studies, Liver Imaging Reporting and Data System (LI-RADS) on contrast-enhanced ultrasound (CEUS) for diagnosing hepatocellular carcinoma (HCC) has shown a satisfactory diagnostic value. However, a unified conclusion on the interobserver stability of this innovative ultrasound imaging has not been determined. The present meta-analysis examined the interobserver agreement of CEUS LI-RADS to provide some reference for subsequent related research.
Research motivation
According to the inclusion and exclusion criteria, we included eight relevant articles to explore interobserver agreement of LI-RADS on CEUS by making a meta-analysis. Finally, meta-analysis results revealed that the summary Kappa value of included studies showed substantial agreement. The heterogeneity factors included the method of enrolling patients, the method of consistency testing, and the race of patients, which should be considered in subsequent study design.
Research objectives
The main objective of the present article is to explore interobserver agreement of LI-RADS on CEUS for diagnosing HCC. Results of meta-analysis showed interobserver agreement is substantial and the heterogeneity factors included the method of enrolling patients, the method of consistency testing, and the race of patients, which should be considered in subsequent study design.
Research methods
The method of this article is to calculate Kappa value to estimate interobserver agreement of LI-RADS on CEUS for diagnosing HCC by using the “meta” package and “metafor” package in R software version 3.6.2 for analysis and synthesis (R Foundation, Vienna, Austria). The result of consistency test has a vital reference value for the stability of LI-RADS.
Research results
This article exhibited substantial interobserver agreement for LI-RADS on CEUS. In addition, meta-regression identified several heterogeneity factors, including the method of enrolling patients, the method of consistency testing, and the race of patients, which should be considered in subsequent study design. Meanwhile, a large, prospective, and multicenter related study is also needed to confirm our results.
Research conclusions
This study reported that interobserver agreement for LI-RADS on CEUS was substantial and that the method of enrolling patients, the method of consistency testing, and the race of patients perhaps interfere with interobserver agreement, which should be considered in subsequent study design.
Research perspectives
The method of enrolling patients, the method of consistency testing, and the race of patients perhaps interfere interobserver agreement and should be considered in future research about LI-RADS on CEUS for diagnosing HCC.
