caa a22 4500 44579805X CHVBK 20180317145132.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s10620-011-1725-8 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1725-8 Interobserver Agreement on the Endosonographic Features of Lymph Nodes in Aerodigestive Malignancies [Elektronische Daten] [Silvio de Melo Jr., Chakri Panjala, Sergio Crespo, Nancy Diehl, Timothy Woodward, Massimo Raimondo, Michael Wallace] Background: Endoscopic ultrasound (EUS) is used to locally stage aerodigestive malignancies. Endosonographic features are used to predict malignant lymph nodes (MLN). Interobserver agreement on the endosonographic features of MLN has not been described. Aims: To evaluate the interobserver agreement among endosonographers on the EUS features of MLN in aerodigestive malignancies along with the specific feature used to make this distinction. Methods: A total of 760 procedures of suspected LN were reviewed. Cases were selected based on cytology-proven malignant or benign LN involvement by FNA with correspondent photodocumentation. Images of each LN were de-identified and distributed to three expert endosonographers. The experts recorded the LN's echogenicity (hypoechoic or other), shape (round or other), border (sharp or fuzzy) and subjective diagnosis (benign or malignant). The relationship between the endosonographers' subjective as well as the pathological diagnosis and LN's endosonographic features were analyzed using logistic regression analysis. Pair-wise comparison between endoscopist and interobserver agreement (kappa statistics) were performed. Results: Images of 41 malignant and 35 benign LN were evaluated. There was fair agreement on shape, Κ=0.35 (95% CI 0.2-0.5), and moderate agreement on echogenicity and borders, Κ=0.46 (95% CI 0.31-0.61) and 0.43 (95% CI 0.27-0.58) respectively. The agreement on malignant LN was good, Κ=0.65 (95% CI 0.5-0.8). The overall diagnostic predictive accuracy ranged from 70 to 77% among the three endoscopists.Two of the three endoscopists assessed shape as the most predictive feature of malignancy (OR 39.4, 95% CI 3.29-470.96). Conclusion: The inter-observer agreement on the individual lymph node features as obtained by EUS is moderate with good overall agreement on the diagnosis. Round shape was the feature most strongly associated with a diagnosis of MLN. Springer Science+Business Media, LLC, 2011 Inter-observer agreement nationallicence Endoscopic ultrasound nationallicence Fine-needle aspiration nationallicence Endosonographic feature nationallicence Malignant lymph node nationallicence de Melo Jr. Silvio Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut Panjala Chakri Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut Crespo Sergio Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut Diehl Nancy Biostatistics Unit, Mayo Clinic Florida, Jacksonville, FL, USA aut Woodward Timothy Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut Raimondo Massimo Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut Wallace Michael Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3204-3208 0163-2116 56:11<3204 2011 56 10620 https://doi.org/10.1007/s10620-011-1725-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1725-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- de Melo Jr Silvio Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Panjala Chakri Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Crespo Sergio Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Diehl Nancy Biostatistics Unit, Mayo Clinic Florida, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Woodward Timothy Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Raimondo Massimo Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Wallace Michael Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3204-3208 0163-2116 56:11<3204 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer