Standardized Cine-Loop Documentation In Renal Ultrasound Facilitates Skill-Mix Between Radiographer And Radiologist

Background: The radiographers' role in ultrasound (US) has been debated due to the operator-dependent aspect of diagnostic US. With standardized cine-loop ultrasound (SCUS) a reliable diagnosis can be achieved by reading SCUS independently from performing the procedure.Purpose: To study the correlation between sonographic findings when SCUS is performed and read by a radiologist and when SCUS is performed by a radiographer and read by a radiologist, and to assess the radiologists' confidence when reading SCUS examinations performed by a radiographer.Material and Methods: Thirty-four patients (64 kidneys) who underwent SCUS of the kidneys were included in this study. All patients underwent two consecutive SCUS examinations, one performed by an experienced radiologist reading his own examination (online), and one performed by a SCUS-trained radiographer, read by an experienced radiologist who was not involved in the examination of the patient (offline). Study reports were made using a structured report form designed for this study. Confidence was measured on a visual analog scale ranging from 0 (no confidence) to 100 (extremely confident). The final diagnosis (the reference standard) was defined as the consensus between two US-experienced radiologists. All personnel were blinded to each other's results.Results: We found discordance between image findings for online and offline in eight out of 64 kidneys. There was no systematic difference between online and offline reading. There was a good correlation between online and offline, kappa 0.75 (95% CI 0.60-0.90, P<0.001). Kappa correlation for online and offline compared to reference standard was 0.94 (95% CI 0.86-1.00, P<0.001) and 0.81 (95% CI 0.66-0.96, P<0.001), respectively. Radiologists reported a confidence level of 88 (range, 74-94) and 85 (range, 67-92) in the online and offline group, respectively (P=0.005).Conclusion: There is a high degree of correlation between reported findings in radiologist and radiographer performed SCUS examinations.