Frontiers in Medicine (Jan 2023)

Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study

  • Andrea Di Matteo,
  • Andrea Di Matteo,
  • Erica Moscioni,
  • Maria Giovanna Lommano,
  • Edoardo Cipolletta,
  • Gianluca Smerilli,
  • Sonia Farah,
  • Carla Airoldi,
  • Sibel Zehra Aydin,
  • Andrea Becciolini,
  • Karina Bonfiglioli,
  • Marina Carotti,
  • Greta Carrara,
  • Tomas Cazenave,
  • Davide Corradini,
  • Micaela Ana Cosatti,
  • Juan Josè de Agustin,
  • Giulia Maria Destro Castaniti,
  • Marco Di Carlo,
  • Eleonora Di Donato,
  • Luca Di Geso,
  • Ashley Elliott,
  • Daniela Fodor,
  • Francesca Francioso,
  • Alessandra Gabba,
  • Alessandra Gabba,
  • Cristina Hernández-Díaz,
  • Rudolf Horvath,
  • Jana Hurnakova,
  • Diogo Jesus,
  • Josefina Marin,
  • Maria Victoria Martire,
  • Riccardo Mashadi Mirza,
  • Marco Massarotti,
  • Alice Andreea Musca,
  • Jagdish Nair,
  • Tadashi Okano,
  • Ioannis Papalopoulos,
  • Javier Rosa,
  • Marcos Rosemffet,
  • João Rovisco,
  • Davide Rozza,
  • Fausto Salaffi,
  • Crescenzio Scioscia,
  • Carlo Alberto Scirè,
  • Maria-Magdalena Tamas,
  • Shun Tanimura,
  • Lucio Ventura-Rios,
  • Catalina Villota-Eraso,
  • Orlando Villota,
  • Paraskevi V. Voulgari,
  • Florentin Ananu Vreju,
  • Gentiana Vukatana,
  • Johana Zacariaz Hereter,
  • Anna Zanetti,
  • Walter Grassi,
  • Emilio Filippucci

DOI
https://doi.org/10.3389/fmed.2022.1090468
Journal volume & issue
Vol. 9

Abstract

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ObjectivesTo investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases.MethodsForty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0–3) and a continuous quantitative measurement (“VAS echogenicity,” 0–100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall’s Tau and Pearson’s Rho coefficients.ResultsThe semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57–0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68–0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. “VAS echogenicity” showed a high reliability both in the inter-observer [ICC = 0.80 (0.75–0.85)] and intra-observer [ICC = 0.88 (0.88–0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and “VAS echogenicity” [ICC = 0.52 (0.50–0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively).ConclusionThe results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases.

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