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Measurement of pancreatic cystic lesions on magnetic resonance imaging: efficacy of standards in reducing inter-observer variability

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Abstract

Purpose

The purpose of this study is to assess inter-observer variability in the measurement of pancreatic cystic lesions with MRI and to determine the impact of measurement standards.

Materials and methods

In this IRB-approved, HIPAA-compliant study with waiver of informed consent, 144 MRI examinations, containing pancreatic cystic lesions measuring between 5 and 35 mm, were reviewed independently by two radiology attendings and two abdominal imaging fellows. Measurements were repeated by the same reviewers 12 weeks later after the introduction of measurement standards. Results were analyzed using within-subject standard deviation, intraclass correlation coefficient, and kappa.

Results

Prior to standardization, the within-subject standard deviation, showing measurement variability in each cyst, was 4.0 mm, which was reduced to 3.3 mm after introduction of measurement standards (p < 0.01). Overall inter-observer agreement, kappa, improved from 0.59 to 0.65 (p = 0.04). The frequency of all four reviewers agreeing on size category increased from 51% to 60%. The intraclass correlation coefficient increased from 0.81 to 0.86.

Conclusions

There is significant and frequent inter-observer variability in the measurement of pancreatic cystic lesions with MRI which could affect clinical management. Implementation of measurement standards reduces measurement variability and aids in preventing erroneous reporting of growth and potentially unwarranted changes in management.

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Authors and Affiliations

  1. Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Ansin 224, Boston, MA, 02115, USA

    Dell P. Dunn, Olga R. Brook, Alexander Brook, Giselle Revah, Sumayya Jawadi, Maryellen Sun, Karen S. Lee & Koenraad J. Mortele

  2. Department of Radiology, David Grant Medical Center, Travis AFB, CA, USA

    Dell P. Dunn

  3. Medical Imaging Department, Ottawa Hospital, Ottawa, ON, Canada

    Giselle Revah

  4. Department of Radiology, St. Vincents Hospital, Worcester, MA, USA

    Sumayya Jawadi

Authors
  1. Dell P. Dunn
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  2. Olga R. Brook
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  3. Alexander Brook
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  4. Giselle Revah
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  5. Sumayya Jawadi
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  6. Maryellen Sun
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  7. Karen S. Lee
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  8. Koenraad J. Mortele
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Corresponding author

Correspondence to Dell P. Dunn.

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Dunn, D.P., Brook, O.R., Brook, A. et al. Measurement of pancreatic cystic lesions on magnetic resonance imaging: efficacy of standards in reducing inter-observer variability. Abdom Radiol 41, 500–507 (2016). https://doi.org/10.1007/s00261-015-0588-4

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  • DOI: https://doi.org/10.1007/s00261-015-0588-4

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