Prospective analysis of inter-observer and intra-observer variability in multi ultrasound descriptor assessment of thyroid nodules
The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a descriptive lexicon. A prospective study was performed on complete ultrasound examinations, including sonoelastography and color Doppler ultrasound of 18 p...
Saved in:
Published in | Journal of ultrasonography Vol. 19; no. 78; pp. 198 - 206 |
---|---|
Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Sciendo
01.11.2019
Exeley Inc |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a descriptive lexicon.
A prospective study was performed on complete ultrasound examinations, including sonoelastography and color Doppler ultrasound of 18 patients with 20 thyroid nodules. A total of 20 records of thyroid nodules from these techniques were duplicated, numbered, and randomly arranged. Five radiologists assessed the recordings independently. Cohen Kappa and Fleiss Kappa statistics were used to determine the degree of intra- and inter-observer agreement.
Mean accuracy rates for all radiologists, for all ultrasound features, ranged from 82.7 to 87.8%. For B-mode and strain elastography, accuracies ranged from 65.0 to 100% and 47.4 to 86.8%, respectively. Concerning intra-observer variability, three radiologists demonstrated almost perfect agreement (the κ-value ranged from 0.81 to 0.86), and a substantial agreement was noted for the two remaining radiologists. The κ-values for inter-observer agreement ranged from 0.61 for macrocalcifications (substantial agreement) to 0.33 for Asteria four-point elastography scale criteria (fair agreement).
The results suggest relatively good inter-observer and excellent intra-observer agreement in the assessment of thyroid nodules using ultrasound, and fair agreement in the case of strain elastography. |
---|---|
AbstractList | The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a descriptive lexicon.
A prospective study was performed on complete ultrasound examinations, including sonoelastography and color Doppler ultrasound of 18 patients with 20 thyroid nodules. A total of 20 records of thyroid nodules from these techniques were duplicated, numbered, and randomly arranged. Five radiologists assessed the recordings independently. Cohen Kappa and Fleiss Kappa statistics were used to determine the degree of intra- and inter-observer agreement.
Mean accuracy rates for all radiologists, for all ultrasound features, ranged from 82.7 to 87.8%. For B-mode and strain elastography, accuracies ranged from 65.0 to 100% and 47.4 to 86.8%, respectively. Concerning intra-observer variability, three radiologists demonstrated almost perfect agreement (the κ-value ranged from 0.81 to 0.86), and a substantial agreement was noted for the two remaining radiologists. The κ-values for inter-observer agreement ranged from 0.61 for macrocalcifications (substantial agreement) to 0.33 for Asteria four-point elastography scale criteria (fair agreement).
The results suggest relatively good inter-observer and excellent intra-observer agreement in the assessment of thyroid nodules using ultrasound, and fair agreement in the case of strain elastography. Aim: The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a descriptive lexicon. Materials and methods: A prospective study was performed on complete ultrasound examinations, including sonoelastography and color Doppler ultrasound of 18 patients with 20 thyroid nodules. A total of 20 records of thyroid nodules from these techniques were duplicated, numbered, and randomly arranged. Five radiologists assessed the recordings independently. Cohen Kappa and Fleiss Kappa statistics were used to determine the degree of intra- and inter-observer agreement. Results: Mean accuracy rates for all radiologists, for all ultrasound features, ranged from 82.7 to 87.8%. For B-mode and strain elastography, accuracies ranged from 65.0 to 100% and 47.4 to 86.8%, respectively. Concerning intra-observer variability, three radiologists demonstrated almost perfect agreement (the κ-value ranged from 0.81 to 0.86), and a substantial agreement was noted for the two remaining radiologists. The κ-values for inter-observer agreement ranged from 0.61 for macrocalcifications (substantial agreement) to 0.33 for Asteria four-point elastography scale criteria (fair agreement). Conclusions: The results suggest relatively good inter-observer and excellent intra-observer agreement in the assessment of thyroid nodules using ultrasound, and fair agreement in the case of strain elastography. Aim: The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a descriptive lexicon. Materials and methods: A prospective study was performed on complete ultrasound examinations, including sonoelastography and color Doppler ultrasound of 18 patients with 20 thyroid nodules. A total of 20 records of thyroid nodules from these techniques were duplicated, numbered, and randomly arranged. Five radiologists assessed the recordings independently. Cohen Kappa and Fleiss Kappa statistics were used to determine the degree of intra- and inter-observer agreement. Results: Mean accuracy rates for all radiologists, for all ultrasound features, ranged from 82.7 to 87.8%. For B-mode and strain elastography, accuracies ranged from 65.0 to 100% and 47.4 to 86.8%, respectively. Concerning intra-observer variability, three radiologists demonstrated almost perfect agreement (the κ-value ranged from 0.81 to 0.86), and a substantial agreement was noted for the two remaining radiologists. The κ-values for inter-observer agreement ranged from 0.61 for macrocalcifications (substantial agreement) to 0.33 for Asteria four-point elastography scale criteria (fair agreement). Conclusions: The results suggest relatively good inter-observer and excellent intra-observer agreement in the assessment of thyroid nodules using ultrasound, and fair agreement in the case of strain elastography. |
Author | Krauze, Agnieszka Słapa, Rafał Z. Migda, Bartosz Dedecjus, Marek Dobruch-Sobczak, Katarzyna Mlosek, Krzysztof Wareluk, Paweł Adamczewski, Zbigniew Lewiński, Andrzej Jakubowski, Wiesław Bakuła-Zalewska, Elwira |
Author_xml | – sequence: 1 givenname: Katarzyna surname: Dobruch-Sobczak fullname: Dobruch-Sobczak, Katarzyna organization: 2 Department of Ultrasound, Institute of Fundamental Technological Research, PAS, Warsaw, Poland – sequence: 2 givenname: Bartosz surname: Migda fullname: Migda, Bartosz organization: 3 Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland – sequence: 3 givenname: Agnieszka surname: Krauze fullname: Krauze, Agnieszka organization: 3 Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland – sequence: 4 givenname: Krzysztof surname: Mlosek fullname: Mlosek, Krzysztof organization: 3 Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland – sequence: 5 givenname: Rafał Z. surname: Słapa fullname: Słapa, Rafał Z. organization: 3 Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland – sequence: 6 givenname: Paweł surname: Wareluk fullname: Wareluk, Paweł organization: 3 Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland – sequence: 7 givenname: Elwira surname: Bakuła-Zalewska fullname: Bakuła-Zalewska, Elwira organization: 4 Department of Pathology The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland – sequence: 8 givenname: Zbigniew surname: Adamczewski fullname: Adamczewski, Zbigniew organization: 6 Polish Mother’s Memorial Hospital-Research Institute, Lodz Poland – sequence: 9 givenname: Andrzej surname: Lewiński fullname: Lewiński, Andrzej organization: 6 Polish Mother’s Memorial Hospital-Research Institute, Lodz Poland – sequence: 10 givenname: Wiesław surname: Jakubowski fullname: Jakubowski, Wiesław organization: 3 Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland – sequence: 11 givenname: Marek surname: Dedecjus fullname: Dedecjus, Marek organization: 7 Department of Nuclear Medicine and Endocrine Oncology, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland |
BookMark | eNpVkkFv1DAQhSNUREvplXOOXLLYjh3bB5BQVaCoEhyoxM2a2JOtV0m82MmiXPnlON2KVS_26M28z5LnvS7OxjBiUbylZEOFEPL9LswbRqjeEFKTF8UF44JWRJJfZ7kmileKE35eXKW0I4TQRvCGsVfFeU0VkTUTF8XfHzGkPdrJH7CEEfol-VSGrvTjhLEKbcJ4wJhbbpUinKQDRA-t7_205FY5zP3ky3xESGHO4w6TjX4_hexOCVMacJxW9PSwxOBdOQY395jeFC876BNePd2Xxf3nm5_XX6u7719urz_dVZYrOVWadZzUSjPbEaRSSy5aooFrAZZTZZkVklGwSFUNoLjChlGiqWoZpQ5ofVncHrkuwM7sox8gLiaAN49CiFsDcfK2R9NoUNS1gHWLnDSitaJx1jHV1Vqg0Jn18cjaz-2AzuL6Nf0z6PPO6B_MNhxMo0QjpcqAd0-AGH7PmCYz-GSx72HEMCfDasakIJqto5vjqM2rShG7_89QYh5zYL6Fe7PmwKw5yIYPR8Mf6PMSHW7jvOTC5LjEvOJ0MmblZKRaKqpV_Q_Erb42 |
CitedBy_id | crossref_primary_10_1093_bjsopen_zrad117 crossref_primary_10_3390_jcm9051504 crossref_primary_10_3390_jcm10020214 crossref_primary_10_3390_jcm9082495 |
ContentType | Journal Article |
Copyright | Polish Ultrasound Society 2019 |
Copyright_xml | – notice: Polish Ultrasound Society 2019 |
CorporateAuthor | Department of Ultrasound, Institute of Fundamental Technological Research, PAS, Warsaw, Poland Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland Department of Nuclear Medicine and Endocrine Oncology, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland Department of Pathology The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Department of Radiology II, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland; Polish Mother’s Memorial Hospital-Research Institute, Poland |
CorporateAuthor_xml | – name: Department of Pathology The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland – name: Department of Nuclear Medicine and Endocrine Oncology, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland – name: Department of Ultrasound, Institute of Fundamental Technological Research, PAS, Warsaw, Poland – name: Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland; Polish Mother’s Memorial Hospital-Research Institute, Poland – name: Department of Radiology II, The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland – name: Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland – name: Diagnostic Imaging Department, Medical University of Warsaw, 2nd Faculty of Medicine with the English Division and the Physiotherapy Division, Warsaw, Poland |
DBID | AAYXX CITATION 7X8 5PM DOA |
DOI | 10.15557/jou.2019.0030 |
DatabaseName | CrossRef MEDLINE - Academic PubMed Central (Full Participant titles) Directory of Open Access Journals |
DatabaseTitle | CrossRef MEDLINE - Academic |
DatabaseTitleList | |
Database_xml | – sequence: 1 dbid: DOA name: Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 2451-070X |
EndPage | 206 |
ExternalDocumentID | oai_doaj_org_article_69a81dbae3be4065bc56dcd28f395e59 10_15557_JoU_2019_0030 10_15557_jou_2019_00301978198 |
GroupedDBID | 5VS ABDBF ADBBV AHGSO ALMA_UNASSIGNED_HOLDINGS AOIJS BCNDV GROUPED_DOAJ HYE IAO IHR ITC KQ8 M48 OK1 RPM Y2W AAYXX CITATION EBS EN8 PGMZT RIG SLJYH 7X8 5PM |
ID | FETCH-LOGICAL-c487t-92f403892cf0e179745b09a495ac418c2c5721ace183aa848e6210918b211da13 |
IEDL.DBID | RPM |
ISSN | 2084-8404 |
IngestDate | Tue Oct 22 14:37:20 EDT 2024 Tue Sep 17 21:26:10 EDT 2024 Fri Aug 16 08:43:32 EDT 2024 Fri Aug 23 04:01:58 EDT 2024 Fri Nov 25 00:38:12 EST 2022 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 78 |
Language | English |
License | This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial NoDerivatives License (CC BY-NC-ND). Reproduction is permitted for personal, educational, non-commercial use, provided that the original article is in whole, unmodified, and properly cited. |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c487t-92f403892cf0e179745b09a495ac418c2c5721ace183aa848e6210918b211da13 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856778/ |
PMID | 31807325 |
PQID | 2322750928 |
PQPubID | 23479 |
PageCount | 9 |
ParticipantIDs | doaj_primary_oai_doaj_org_article_69a81dbae3be4065bc56dcd28f395e59 pubmedcentral_primary_oai_pubmedcentral_nih_gov_6856778 proquest_miscellaneous_2322750928 crossref_primary_10_15557_JoU_2019_0030 walterdegruyter_journals_10_15557_jou_2019_00301978198 |
PublicationCentury | 2000 |
PublicationDate | 2019-11-01 |
PublicationDateYYYYMMDD | 2019-11-01 |
PublicationDate_xml | – month: 11 year: 2019 text: 2019-11-01 day: 01 |
PublicationDecade | 2010 |
PublicationTitle | Journal of ultrasonography |
PublicationYear | 2019 |
Publisher | Sciendo Exeley Inc |
Publisher_xml | – name: Sciendo – name: Exeley Inc |
SSID | ssj0001654622 |
Score | 2.1904457 |
Snippet | The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a descriptive... Aim: The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a... Aim: The aim of this study was to evaluate the inter- and intra-observer variability and accuracy of ultrasound assessment of thyroid nodules using a... |
SourceID | doaj pubmedcentral proquest crossref walterdegruyter |
SourceType | Open Website Open Access Repository Aggregation Database Publisher |
StartPage | 198 |
SubjectTerms | inter-observer variability intra-observer variability Medicine sonoelastography thyroid nodule ultrasound |
SummonAdditionalLinks | – databaseName: Directory of Open Access Journals dbid: DOA link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1LT9wwELYqDqgXVGirbnnIlSr1FJGHnbWPgEAIiaqHrsTNGj_SIqEYZXdBe-WXM-Nk2V0uXLjkYCeO7fFjPs_MZ8Z-5q7yGnMyCYAApc5FpkHUGVRKVKHQiIsodvj6d305EVc38mbtqi_yCevpgfuOO641oEplIVQ24OYjrZO1d75UTaVlkH3oXq7XwFQ6XaEYnWRCKHMlMkQxYmBslFKOj6_ihLy6iKqS3J_XdqRE3L-hbb72ldx5THZsH_5188VsaTdN29HFJ7Yz6JH8pK__LvsQ2j22fT1Yyj-zpz9dXEZRchiYR3hsOPFDdFm0dBobOszylNTBKukB4XPP3r3ALJ5cDjk-OpjSHUzch36pifj1C68nFY0y7-Kt523087sw_cImF-d_zy6z4b6FzCFsmWW6bATx7ZWuyQNO1LGQNkfJaQlOFMqVTiJeBBdwGQBQQoWaur5QFlGkh6L6yrba2IZvjNtCa_C5VN6iytBIK6QAhDIO0RUgSBqxX8s-N_c9rYYhOELSMSgdQ9Ih3tJ8xE5JJC9vER12SsBBYoZBYt4aJCP2YylQg9OHbCLQhjifGlQoieFel1il8YakN_64mdPe_k9E3LWSxL83YvWrMWGGhWC6ahSmrBpVENOYVt_fo2377COV28dHHrCtWTcPh6gozexRmhPPOngT1Q priority: 102 providerName: Directory of Open Access Journals – databaseName: Scholars Portal Open Access Journals dbid: M48 link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELZQkRCXiqdYXjISEqegxLFT-4AQIKqqUhEHVuotGj9SKlUxeHdp98ovZ8ZJukrhxCWHcZzEHtuZzzPzmbHXpau9wZJCASBAaUpZGJBNAbWWdagM4iLKHT750hwt5fGpOt3FP40duPontKPzpJbp4u3Vz-17nPDv8uk9ChE91qIgLWKerBG-3xaUBkRhfKOpn_dbKGtHiJG38e9qs_9Spu-f2Zw3Iyb3L7M324eztNmuJ-9p_ikd3mP7ozXJPwzqv89uhf4Bu3My-ssfst9fU5xyKTmM_CM8dpxYIlIRLe3JhoRFnkQJdqJfCKIHDu8tFvEceMjxkmBFJzFxH4YFJ2Lta3ZPejRqPsVzz_voNxdh9YgtDz9_-3RUjKcuFA7By7owopPEuidcVwacrgdS2RL1ZxQ4WWknnELUCC7gYgCgpQ6NIHZRbRFLeqjqx2yvj314writjAFfKu0tGg6dslJJQEDjEGMBQqUFezP1eftjINdoCZSQdtrjuGxJO8ReWi7YR1LJ9V1Eip0FMZ214xxrGwNofVsItQ1opyjrVOOdF7qrjQrKLNirSaEtTiLyjEAf4mbVollJPPdG4CcdzDQ9e-O8pD__num4G62IhW_Bmhtjop1G865RKNk1qiK-MaOf_m_FZ-wuiYbMyOdsb5024QWaSGv7Mo_9P2nqE80 priority: 102 providerName: Scholars Portal |
Title | Prospective analysis of inter-observer and intra-observer variability in multi ultrasound descriptor assessment of thyroid nodules |
URI | http://www.degruyter.com/doi/10.15557/jou.2019.0030 https://search.proquest.com/docview/2322750928 https://pubmed.ncbi.nlm.nih.gov/PMC6856778 https://doaj.org/article/69a81dbae3be4065bc56dcd28f395e59 |
Volume | 19 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LT9wwELaAQ9UL6lPdPlAqVeopbB52sI-AQAhpKw5diZs1foSuVGLk3W3Ftb-8M07Cshy55GAnjuMZO_N5Zj4z9q2wtVNYkwsABChNwXMFvMmhlrz2pUJcRLnDsx_NxZxfXovrHSbGXJgUtG_N4rD7fXvYLX6l2Mq7Wzsd48SmV7PTRgriPZvusl1U0EcQPW2sUHpO8h5UheQ5Ahg-kDUKgej_MswpoItYKms6Bg51GrWcTsp-9F9K9P1bNufTiMn9v8mb7fxNXN-vRu9p-imdv2L7gzWZHfe9fs12fPeGvZgN_vK37N9VDGMuZQYD_0gW2oxYImIeDO3J-ohVjooibIr-IIjuObzvsSpLgYcZXiIs6SSmzPl-wQn49AO7JzWNko9h4bIuuDWO5Ds2Pz_7eXqRD6cu5BbByypXVcuJda-ybeFxuh5xYQqUnxJgeSltZQWiRrAeFwMAyaVvKmIXlQaxpIOyfs_2utD5DywzpVLgCiGdQcOhFYYLDghoLGIsQKg0Yd_HMdd3PbmGJlBCgtIoKE2CIvbSYsJOSCQPdxEpdioI8UYPqqEbBWh9G_C18WinCGNF46yrZFsr4YWasK-jQDVOIvKMQOfDeqnRrCSee1Vhl462JL31xu0a1M5Exz1o44Q1T3RCD8vBcvNRWLL5qJL4xpT8-OxXfmIvqbE-NfIz21vFtf-CNtLKHKS9BbzOuDxI8-M_c9QVQg |
link.rule.ids | 230,315,730,783,787,867,888,2109,2228,24331,27937,27938,53805,53807 |
linkProvider | National Library of Medicine |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELZKkaCX8laXZ5CQOGU3Dzu1j1BRLaVb9dBFvVl-paygcZVNQOXIL2fGSbrdvcElB09elj8782VmPhPyLjG5FWCJmVJAUIqExkLRIlY5p7lLBfAirB2enRTTOT06Z-dbhA21MCFp3-jFuPpxOa4W30Ju5dWlmQx5YpPT2UHBGeqeTe6QuzBfE3aLpIdfK1igE-IHWcJpDBSG9nKNjAH_P_JzTOlCncocN4IDVAPOca_sW1-mIOC_5nVu5kzu_grxbOsu6va6GeKn4bN0-IB8HTrUZaN8H7eNHpvfG1qP_9zjh2S3d1SjD535Edly1WNyb9aH4p-QP6e1H8o0I9VLm0S-jFCAoo69xt-9rgaTxaZarZp-Aj_v5MGvwRSFnMYIDrVa4iZPkXXdWubh6hvhULw1gKr2CxtV3rbwyk_J_PDT2cE07jd0iA3woiYWWUlR0C8zZeJgJdinTCcADcGUoSk3mWFASJVxsM4oxSl3RYbCpVwDTbUqzZ-R7cpXbo9EOhVC2YRxq8EnKZmmjCrgSgbomwIWNiLvh8GUV51uh0S-gwiQgACJCEBh1GREPuJY35yFetuhwdcXsh8DWQgFjr1WLtcOXCCmDSussRkvc8EcEyPydkCKhPmJQRdVOd8uJXisKKEvMnil_TUIrT1x3QIwCErf_bCPSLEBNtmvNMtVp6Bl1akUpcwEf_7fj3xD7k_PZsfy-PPJlxdkB2_cVWC-JNtN3bpX4Io1-nWYeH8BxmY1eQ |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELagSBWX8hbLM0hInLJ52Vn7CIVVKWy1B1aquFh-paygySqbgMqRX86Mk3Qfx15ysBMnlj8783nG3xDyNjaZFVATMqWAoOQxDYWieagyTjOXCOBFeHZ4dpafLOjpOTvfSvXlg_aNXo7LX5fjcvnDx1auLk00xIlF89lxzhnqnkUrW0S3yR2GoulbRN1vr-AhHe9DSGNOQ6AxtJdsZIxNotNqgWFdqFWZYTI4QDZgHfNlb_2dvIj_juW5Hzd59Mf7tK27qNurZvCh-l_T9B75PnSqi0j5OW4bPTZ_9_Qeb9Tr--SoN1iD990tD8gtVz4kh7PeJf-I_JvX1XBcM1C9xElQFQEKUdRhpXHb19VQZbGoVpui38DTO5nwK6gKfGxjAJdarTHZU2Bdt6ZV8PS1gCg2DeCqq6UNysq28NmPyWL66dvxSdgndggN8KMmFGlBUdgvNUXsYEWYUKZjgIhgytCEm9QwIKbKOFhvlOKUuzxFAVOuga5alWRPyEFZle4pCXQihLIx41aDbVIwTRlVwJkM0DgFbGxE3g0DKledfodE3oMokIACiShAgdR4RD7geF_fhbrbvqCqL2Q_DjIXCgx8rVymHZhCTBuWW2NTXmSCOSZG5M2AFgnzFJ0vqnRVu5ZguaKUvkjhkyY7MNp5424NQMErfvdDPyL5HuBkv-KsN52Ckk2nEpQ0E_zZjV_5mhzOP07l189nX56Tu9hudxDzBTlo6ta9BIus0a_83PsPUds3-Q |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Prospective+analysis+of+inter-observer+and+intra-observer+variability+in+multi+ultrasound+descriptor+assessment+of+thyroid+nodules&rft.jtitle=Journal+of+ultrasonography&rft.au=Dobruch-Sobczak%2C+Katarzyna&rft.au=Migda%2C+Bartosz&rft.au=Krauze%2C+Agnieszka&rft.au=Mlosek%2C+Krzysztof&rft.date=2019-11-01&rft.pub=Sciendo&rft.eissn=2451-070X&rft.volume=19&rft.issue=78&rft.spage=198&rft.epage=206&rft_id=info:doi/10.15557%2Fjou.2019.0030&rft.externalDBID=n%2Fa&rft.externalDocID=10_15557_jou_2019_00301978198 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2084-8404&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2084-8404&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2084-8404&client=summon |