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| 1 | Reliability of ultrasound ovarian-adnexal reporting and data system amongst less experienced readers before and after training显示文摘BACKGROUND The 2018 ovarian-adnexal reporting and data system(O-RADS)guidelines are aimed at providing a system for consistent reports and risk stratification for ovarian lesions found on ultrasound.It provides key characteristics and findings for lesions,a lexicon of descriptors to communicate findings,and risk characterization and associated follow-up recommendation guidelines.However,the ORADS guidelines have not been validated in North American institutions or amongst less experienced readers.AIM To evaluate the diagnostic accuracy and inter-reader reliability of ultrasound ORADS risk stratification amongst less experienced readers in a North American institution with and without pre-test training.METHODS A single-center retrospective study was performed using 100 ovarian/adnexal lesions of varying O-RADS scores.Of these cases,50 were allotted to a training cohort and 50 to a testing cohort via a non-randomized group selection process in order to approximately equal distribution of O-RADS categories both within and between groups.Reference standard O-RADS scores were established through consensus of three fellowship-trained body imaging radiologists.Three PGY-4 residents were independently evaluated for diagnostic accuracy and inter-reader reliability with and without pre-test O-RADS training.Sensitivity,specificity,positive predictive value,negative predictive value(NPV),and area under the curve(AUC)were used to measure accuracy.Fleiss kappa and weighted quadratic(pairwise)kappa values were used to measure inter-reader reliability.Statistical significance was P<0.05.RESULTS Mean patient age was 40±16 years with lesions ranging from 1.2 to 22.5 cm.Readers demonstrated excellent specificities(85%-100%pre-training and 91%-100%post-training)and NPVs(89%-100%pre-training and 91-100%post-training)across the O-RADS categories.Sensitivities were variable(55%-100%pre-training and 64%-100%post-training)with malignant ORADS 4 and 5 Lesions pre-training and post-training AUC values of 0.87-0.95 and 0.94-098,respectively(P<0.001).Nineteen of 22(86%)misclassified cases in pre-training were related to mischaracterization of dermoid features or wall/septation morphology.Fifteen of 17(88%)of posttraining misclassified cases were related to one of these two errors.Fleiss kappa inter-reader reliability was‘good’and pairwise inter-reader reliability was‘very good’with pre-training and post-training assessment(k=0.76 and 0.77;and k=0.77-0.87 and 0.85-0.89,respectively).CONCLUSION Less experienced readers in North America achieved excellent specificities and AUC values with very good pairwise inter-reader reliability.They may be subject to misclassification of potentially malignant lesions,and specific training around dermoid features and smooth vs irregular inner wall/septation morphology may improve sensitivity. | Prayash Katlariwala Mitchell P Wilson Yeli Pi Baljot S Chahal Roger Croutze Deelan Patel Vimal Patel Gavin Low | 2022 | World Journal of Radiology2022，14，9： | 2 |
| 2 | Ultrasensitive detection of testosterone using conjugate linker technology in a nanoparticle-enhaneed surface plasmon resonance biosensor 显示文摘 | Mitchell JS Lowe TE | 2009 | Biosens Bioelectron2009，24，7： | 1 |
| 3 | Predicting phospholipidosis using machine learning显示文摘 | Lowe R Glen R C Mitchell J B O | 2010 | Mol Pharmaceutics2010，7，5： | 1 |
| 4 | Operational characteristics of ( 11 ) c - chaline positron emission tomography/computerized tomography for prostate cancer with biochemical recurrence after initial treatment 显示文摘 | Mitchell CR Lowe VJ Rangel LJ | 2013 | J Urol2013，189，4： | 1 |
| 5 | Association between raised inflammatory markers and cognitive decline in elderly people with type2 diabetes:the Edinburgh Type 2 Diabetes Study显示文摘 | Marioni RE Strachan MW Reynolds RM Lowe GD Mitchell RJ Fowkes FG | 2010 | Diabetes2010，59，3： | 1 |
| 6 | Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction显示文摘 | Marc Klapholz Matthew Maurer April M. Lowe Frank Messineo Jay S. Meisner Judith Mitchell Jill Kalman Robert A. Phillips Richard Steingart Edward J. Brown Robert Berkowitz Robert Moskowitz Anita Soni Donna Mancini Rachel Bijou Khashayar Sehhat Nikita Varsh | 2004 | Journal of the American College of Cardiology2004，，8： | 1 |
| 7 | The Society of Thoracic Surgeons Guidelines on the Diagnosis and Staging of Patients With Esophageal Cancer显示文摘 | Thomas K. Varghese Wayne L. Hofstetter Nabil P. Rizk Donald E. Low Gail E. Darling Thomas J. Watson John D. Mitchell Mark J. Krasna | 2013 | The Annals of Thoracic Surgery2013，，1： | 1 |
| 8 | Ultrasensitive detection of testosterone using conjugate linker technology in a nanoparticle-enhanced surface plasmon resonance biosensor显示文摘 | John S. Mitchell Tim E. Lowe | 2008 | Biosensors and Bioelectronics2008，，7： | 1 |
| 9 | Flipped the Sociology Classroom:Towards A Practice of Online Pedagogy显示文摘 | Martin Forsey Mitchell Low David Glance | 2012 | Journal of Sociology2012，49，4： | 1 |
| 10 | Two-point Dixon and six-point Dixon magnetic resonance techniques in the detection,quantification and grading of hepatic steatosis显示文摘BACKGROUND Hepatic steatosis is a very common problem worldwide.AIM To assess the performance of two-and six-point Dixon magnetic resonance(MR)techniques in the detection,quantification and grading of hepatic steatosis.METHODS A single-center retrospective study was performed in 62 patients with suspected parenchymal liver disease.MR sequences included two-point Dixon,six-point Dixon,MR spectroscopy(MRS)and MR elastography.Fat fraction(FF)estimates on the Dixon techniques were compared to the MRS-proton density FF(PDFF).Statistical tests used included Pearson’s correlation and receiver operating characteristic.RESULTS FF estimates on the Dixon techniques showed excellent correlation(≥0.95)with MRS-PDFF,and excellent accuracy[area under the receiver operating characteristic(AUROC)≥0.95]in:(1)Detecting steatosis;and(2)Grading severe steatosis,(P<0.001).In iron overload,two-point Dixon was not evaluable due to confounding T2*effects.FF estimates on six-point Dixon vs MRS-PDFF showed a moderate correlation(0.82)in iron overload vs an excellent correlation(0.97)without iron overload,(P<0.03).The accuracy of six-point Dixon in grading mild steatosis improved(AUROC:0.59 to 0.99)when iron overload cases were excluded.The excellent correlation(>0.9)between the Dixon techniques vs MRSPDFF did not change in the presence of liver fibrosis(P<0.01).CONCLUSION Dixon techniques performed satisfactorily for the evaluation of hepatic steatosis but with exceptions. | Mohamed Elfaal Alanna Supersad Craig Ferguson Stephanie Locas Florin Manolea Mitchell P Wilson Medica Sam Wendy Tu Gavin Low | 2023 | World Journal of Radiology2023，15，10： | 0 |
| 11 | Effect of training on resident inter-reader agreement with American College of Radiology Thyroid Imaging Reporting and Data System显示文摘BACKGROUND The American College of Radiology Thyroid Imaging Reporting and Data System(ACR TI-RADS)was introduced to standardize the ultrasound characterization of thyroid nodules.Studies have shown that ACR-TIRADS reduces unnecessary biopsies and improves consistency of imaging recommendations.Despite its widespread adoption,there are few studies to date assessing the inter-reader agreement amongst radiology trainees with limited ultrasound experience.We hypothesize that in PGY-4 radiology residents with no prior exposure to ACR TIRADS,a statistically significant improvement in inter-reader reliability can be achieved with a one hour training session.AIM To evaluate the inter-reader agreement of radiology residents in using ACR TIRADS before and after training.METHODS A single center retrospective cohort study evaluating 50 thyroid nodules in 40 patients of varying TI-RADS levels was performed.Reference standard TI-RADS scores were established through a consensus panel of three fellowship-trained staff radiologists with between 1 and 14 years of clinical experience each.Three PGY-4 radiology residents(trainees)were selected as blinded readers for this study.Each trainee had between 4 to 5 mo of designated ultrasound training.No trainee had received specialized TI-RADS training prior to this study.Each of the readers independently reviewed the 50 testing cases and assigned a TI-RADS score to each case before and after TI-RADS training performed 6 wk apart.Fleiss kappa was used to measure the pooled inter-reader agreement.The relative diagnostic performance of readers,pre-and post-training,when compared against the reference standard.RESULTS There were 33 females and 7 males with a mean age of 56.6±13.6 years.The mean nodule size was 19±14 mm(range from 5 to 63 mm).A statistically significant superior inter-reader agreement was found on the post-training assessment compared to the pre-training assessment for the following variables:1.“Shape”(k of 0.09[slight]pre-training vs 0.67[substantial]post-training,P<0.001),2.“Echogenic foci”(k of 0.28[fair]pre-training vs 0.45[moderate]post-training,P=0.004),3.‘TI-RADS level’(k of 0.14[slight]pre-training vs 0.36[fair]post-training,P<0.001)and 4.‘Recommendations’(k of 0.36[fair]pre-training vs 0.50[moderate]post-training,P=0.02).No significant differences between the preand post-training assessments were found for the variables'composition','echogenicity'and'margins'.There was a general trend towards improved pooled sensitivity with TI-RADS levels 1 to 4 for the post-training assessment while the pooled specificity was relatively high(76.6%-96.8%)for all TI-RADS level.CONCLUSION Statistically significant improvement in inter-reader agreement in the assigning TI-RADS level and recommendations after training is observed.Our study supports the use of dedicated ACR TI-RADS training in radiology residents. | Yang Du Meredith Bara Prayash Katlariwala Roger Croutze Katrin Resch Jonathan Porter Medica Sam Mitchell P Wilson Gavin Low | 2022 | World Journal of Radiology2022，14，1： | 0 |
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