Agreement between diagnostic imaging methods for the evaluation of lymphadenopathies in HIV-infected/AIDS patients

Abstract Objective: To assess the percent agreement between diagnostic imaging modalities for the evaluation of lymphadenopathies in HIV-infected/AIDS patients. Materials and Methods: This was an open, comparative, prospective study of diagnostic imaging methods for lymphadenopathy evaluation. We evaluated 30 patients (19 men and 11 women). All underwent ultrasound and computed tomography (CT). Twenty of the patients also underwent magnetic resonance imaging (MRI). We determined the percent agreement between two examiners using the various imaging methods to evaluate lymphadenopathies. Results: CT had the highest percent agreement, at 93.3%, with a kappa coefficient of 0.85, corresponding to 28 of the 30 examinations. When we compared the percent agreement between the two examiners and between CT and ultrasound, examiner 1 had an observed rate of 80.0%, with a kappa of 0.49, corresponding to 24 of the 30 examinations, whereas examiner 2 had a rate of 70.0%, with a kappa of 0.31, corresponding to 21 of the 30 examinations. Between MRI and CT, the percent agreement for examiner 1 was 50.0%, with a kappa of −0.18, corresponding to 10 of the 20 examinations, whereas that for examiner 2 was 85.0%, with a kappa of 0.69, corresponding to 17 of the 20 examinations. For MRI and ultrasound, examiner 1 had a percent agreement of 70.0%, with a kappa of 0.20, corresponding to 14 of the 20 examinations, and examiner 2 had a percent agreement of 75.0%, with a kappa of 0.38, corresponding to 15 of the 20 examinations. Conclusion: This study indicates that intermethod agreement is highly dependent on the way in which the research is conducted, rather than on the level of experience of the examiner.

**研究目的**：评估各类诊断成像模态在HIV感染/艾滋病患者淋巴结病变评估中的一致性百分比。
**材料与方法**：本研究为一项针对淋巴结病变评估所用诊断成像方法的开放、对照、前瞻性研究。共纳入30例患者（男性19例，女性11例），所有患者均接受超声（ultrasound）与计算机断层扫描（computed tomography, CT）检查，其中20例患者额外接受磁共振成像（magnetic resonance imaging, MRI）检查。本研究旨在确定两名阅片者采用各类成像方法评估淋巴结病变时的一致性百分比。
**研究结果**：CT的一致性百分比最高，达93.3%，kappa系数为0.85，对应30例检查中的28例。对比两名阅片者以及CT与超声的一致性结果时，阅片者1的观测符合率为80.0%，kappa系数为0.49，对应30例检查中的24例；阅片者2的符合率为70.0%，kappa系数为0.31，对应30例检查中的21例。在MRI与CT的对比中，阅片者1的一致性百分比为50.0%，kappa系数为-0.18，对应20例检查中的10例；而阅片者2的一致性百分比为85.0%，kappa系数为0.69，对应20例检查中的17例。针对MRI与超声的对比，阅片者1的一致性百分比为70.0%，kappa系数为0.20，对应20例检查中的14例；阅片者2的一致性百分比为75.0%，kappa系数为0.38，对应20例检查中的15例。
**研究结论**：本研究表明，不同成像方法间的一致性高度依赖于研究开展方式，而非阅片者的经验水平。