ArticleAbdominal radiology (New York)2026
Interreader agreement for image quality, observation detection, and proposed AMRI-LI-RADS classification in non-contrast abbreviated MRI for hepatocellular carcinoma surveillance among early-to-mid career radiologists.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAbbreviated MRI (AMRI) protocols may offer an alternative to ultrasound for hepatocellular carcinoma (HCC) surveillance in high-risk patients, but standardized assessment and interreader agreement are essential for clinical implementation. As surveillance programs expand, these examinations will increasingly be interpreted by early-to-mid career radiologists, making it critical to evaluate agreement within this workforce segment. PURPOSE: To evaluate interreader agreement for image quality assessment, observation detection, and proposed AMRI-LI-RADS classification in non-contrast (NC) AMRI for HCC surveillance among early-to-mid career radiologists, and to assess the influence of experience within this cohort on interpretation patterns.
methodsIn this retrospective analysis of 614 NC-AMRI examinations (HASTE and DWI sequences), four early-to-mid career radiologists (2, 4.5, 5.5, and 5.5 years of post-training experience in abdominal MRI) independently evaluated image quality (5-point scale), presence of observations (≥ 10mm), and proposed AMRI-LI-RADS classification (benign, equivocal, or malignant). Agreement was assessed using percentage agreement and prevalence-adjusted bias-adjusted kappa (PABAK) for image quality, and Cohen's kappa for observation detection and proposed AMRI-LI-RADS classification. Friedman test, Cochran's Q test, and Bhapkar test for marginal homogeneity were used to evaluate differences across experience levels, with subsequent pairwise comparisons and regression analyses to quantify experience-related effects.
resultsMost examinations received excellent image quality ratings across all readers (HASTE: 73.3%-97.1%; DWI: 66.3%-93.7%). Interreader agreement was substantial for dichotomized image quality (PABAK: 0.807-0.995), observation detection (kappa: 0.742-0.993), and proposed AMRI-LI-RADS classification (kappa: 0.641-0.915). Reader experience significantly influenced assessments , with less experienced readers assigning higher quality scores and detecting more observations. There was no significant influence of reader experience on AMRI-LIRADS classification.
conclusionNC-AMRI demonstrates high interreader agreement for image quality assessment, observation detection, and proposed AMRI-LI-RADS classification among early-to-mid career radiologists, supporting reproducibility of NC-AMRI interpretation. However, significant reader-dependent differences in quality ratings and observation detection indicate systematic variations in reader thresholds, highlighting the importance of standardized interpretation criteria and reader calibration when implementing NC-AMRI surveillance programs.
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