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Related Concept Videos

Assessment of the Rectum and Anus01:25

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
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Updated: Sep 20, 2025

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Intra- and Interobserver Variability of Shear Wave Elastography in Rectal Cancer.

Martina Kastrup Loft1,2,3, Malene Roland Vils Pedersen1,2,3, Peter Grimm1

  • 1Department of Radiology, Lillebaelt Hospital, Clinical Cancer Centre, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark.

Cancers
|June 10, 2022
PubMed
Summary

Endorectal ultrasound elastography shows high interobserver agreement for rectal cancer staging. Agreement is excellent regardless of operator experience, especially when using mean values from multiple regions of interest.

Keywords:
interobserverrectal neoplasmsreproducibilityshear wave elastographyultrasound

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Area of Science:

  • Medical Imaging
  • Gastroenterology
  • Oncology

Background:

  • Endorectal ultrasound (ERUS) is crucial for evaluating complex rectal adenomas and cancer.
  • Elastography measurements enhance ERUS accuracy.
  • High interobserver agreement is essential for clinical reliability.

Purpose of the Study:

  • To assess interobserver agreement of real-time elastography in ERUS.
  • To evaluate intra- and interobserver agreement between experienced and inexperienced operators.

Main Methods:

  • Prospective inclusion of patients with complex rectal polyps or suspected malignancy undergoing ERUS.
  • Independent scanning by two operators.
  • Assessment of previously obtained images by four observers using three region of interest (ROI) methods, with reassessment after three months for intraobserver variability.

Main Results:

  • Substantial agreement for T stage (kappa: 0.86) and fair for N stage (kappa: 0.73).
  • Good agreement for Emean (ICC 0.94) and fair for Emax (ICC 0.85) in shear wave elastography (SWE).
  • Good to excellent intra- and interobserver agreement across all ROI methods, irrespective of operator experience.

Conclusions:

  • Shear wave elastography (SWE) demonstrates high interobserver agreement in clinical ERUS settings.
  • Using the mean value of several ROIs yielded the best agreement.
  • High intra- and interobserver agreement was achieved regardless of operator experience.