Saba Sohail, Mukhtiar Memon.
Inter-observer agreement for detection and grading of hepatic steatosis- an ultrasound based study.
Pak J Radiol May ;28(1):30-4.

Objectives: To determine the inter observer agreement of ultrasound diagnosis of the severity and grading of steatosis in patients with HCV Methods: Patients with HCV were evaluated, from March 2008-August 2010 at Radiology department, Dow Medical College and Civil Hospital Karachi, with ultrasound for detection and grading of steatosis and fibrosis using a standardized set of criteria. The same sets of images were reviewed by the same radiologists 5 years later (2015) for determining the agreement in the grading. Kappa (k) statistics were utilized. Present results were compared with that of the pilot study conducted in 2007 on� 100 images. Results: 452 set of images were reviewed by three radiologists, designated A, B and C. The inter observer agreement was satisfactory to good with k=0.8 for no steatosis, 0.4 for mild steatosis, 0.7 for moderate steatosis and 0.9 for severe steatosis. The inter-observer agreement in the pilot study in 2007 had shown k - values of 0.81 for no steatosis, 0.5 for mild steatosis, 0.8 for moderate steatosis and 0.9 for severe steatosis. � Conclusions: The studied criteria for ultrasound diagnosis and grading of hepatic steatosis had persistently good inter-observer agreement for absence, and moderate to severe grades of steatosis. The agreement was low for mild steatosis. Key words: Fatty liver, Hepatic steatosis, ultrasound, diagnosis, grading, �Inter observer agreement.

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