TY - JOUR
T1 - Inter- and intra-observer variability of radial-endobronchial ultrasound image interpretation for peripheral pulmonary lesions
AU - Moulton, Nathaniel
AU - Abbasi, Mohammed
AU - Ahmad, Danish
AU - Burks, Allen
AU - Chenna, Praveen
AU - Haas, Kevin
AU - Loiselle, Andrea
AU - Mekhaiel, Essam
AU - Pilli, Suchitra
AU - Sadoughi, Ali
AU - Lydon, Brandt
AU - Patel, Tej
AU - Chen, Alexander C.
N1 - Publisher Copyright:
© Journal of Thoracic Disease. All rights reserved.
PY - 2024/1
Y1 - 2024/1
N2 - Background: Radial probe endobronchial ultrasound (R-EBUS) is often utilized in guided bronchoscopy for the diagnosis of peripheral pulmonary lesions. R-EBUS probe positioning has been shown to correlate with diagnostic yield, but overall diagnostic yield with this technology has been inconsistent across the published literature. Currently there is no standardization for R-EBUS image interpretation, which may result in variability in grading concentricity of lesions and subsequently procedure performance. This was a survey-based study evaluating variability among practicing pulmonologists in R-EBUS image interpretation. Methods: R-EBUS images from peripheral bronchoscopy cases were sent to 10 practicing Interventional Pulmonologists at two different time points (baseline and 3 months). Participants were asked to grade the images as concentric, eccentric, or no image. Cohen’s Kappa-coefficient was calculated for inter- and intra-observer variability. Results: A total of 100 R-EBUS images were included in the survey. There was 100% participation with complete survey responses from all 10 participants. Overall kappa-statistic for inter-observer variability for Survey 1 and 2 was 0.496 and 0.477 respectively. Overall kappa-statistic for intra-observer variability between the two surveys was 0.803. Conclusions: There is significant variability between pulmonologists when characterizing R-EBUS images. However, there is strong intra-rater agreement from each participant between surveys. A standardized approach and grading system for radial EBUS patterns may improve inter-observer variability in order to optimize our clinical use and research efforts in the field.
AB - Background: Radial probe endobronchial ultrasound (R-EBUS) is often utilized in guided bronchoscopy for the diagnosis of peripheral pulmonary lesions. R-EBUS probe positioning has been shown to correlate with diagnostic yield, but overall diagnostic yield with this technology has been inconsistent across the published literature. Currently there is no standardization for R-EBUS image interpretation, which may result in variability in grading concentricity of lesions and subsequently procedure performance. This was a survey-based study evaluating variability among practicing pulmonologists in R-EBUS image interpretation. Methods: R-EBUS images from peripheral bronchoscopy cases were sent to 10 practicing Interventional Pulmonologists at two different time points (baseline and 3 months). Participants were asked to grade the images as concentric, eccentric, or no image. Cohen’s Kappa-coefficient was calculated for inter- and intra-observer variability. Results: A total of 100 R-EBUS images were included in the survey. There was 100% participation with complete survey responses from all 10 participants. Overall kappa-statistic for inter-observer variability for Survey 1 and 2 was 0.496 and 0.477 respectively. Overall kappa-statistic for intra-observer variability between the two surveys was 0.803. Conclusions: There is significant variability between pulmonologists when characterizing R-EBUS images. However, there is strong intra-rater agreement from each participant between surveys. A standardized approach and grading system for radial EBUS patterns may improve inter-observer variability in order to optimize our clinical use and research efforts in the field.
KW - Radial probe endobronchial ultrasound (R-EBUS)
KW - navigational bronchoscopy
KW - observer variability
KW - peripheral bronchoscopy
KW - peripheral pulmonary lesions
UR - http://www.scopus.com/inward/record.url?scp=85184052325&partnerID=8YFLogxK
U2 - 10.21037/jtd-23-998
DO - 10.21037/jtd-23-998
M3 - Article
C2 - 38410559
AN - SCOPUS:85184052325
SN - 2072-1439
VL - 16
SP - 450
EP - 456
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 1
ER -