PURPOSE To study the interobserver agreement for the analysis of lesion filling following cementoplasty of an acetabular osteolytic lesion, and investigate how subjective analysis compares to volumetric analysis. MATERIALS AND METHODS A total of 21 acetabular osteolysis were retrospectively analysed on pre- and immediate post-cementoplasty CT-scans by two senior interventional radiologists and one resident using a 4 grade scale to quantify lesion filling (Fsubjective): F ≤ 25%, 25% < F ≤ 50%, 50% < F ≤ 75% or F > 75%. Volumetric analysis (Fvolumetric) was performed with the delineation of the osteolysis and the cement using regions of interest. The interobserver agreement for Fsubjective was evaluated using the Fleiss' Kappa test for the 4 grade scale and for a simplified 2 grades scale (F ≤ 50% and F > 50%). The performance of Fsubjective versus Fvolumetric (considered as the gold standard) was then evaluated for each reader using the calculation of accuracy and error to reference for the 4 grades scale and accuracy, sensitivity, specificity, positive predictive value and negative predictive value for the 2 grade scale. RESULTS Interobserver agreement was considered as very low (< 0.2) for the 4 grade scale analysis and as low (> 0.2 and < 0.4) for the 2 grade scales analysis with kappa factors of 0.196 and 0.36 respectively. Compared to volumetric analysis, the overall accuracy of the 4- and 2- grade scales were 36.5% and 60% respectively. CONCLUSION Subjective evaluation of cement filling of an acetabular osteolytic lesion is associated with poor interobserver agreement and overestimation of the percentage compared to volumetric analysis.

中文翻译：

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经皮骨水泥成形术治疗髋臼溶骨病变的主观分析：是否可靠？

目的研究髋臼溶骨病灶整形术后病灶充盈分析的观察者间协议，并研究主观分析与体积分析的比较。材料与方法由两名高级介入放射科医生和一名住院医师在4个等级的量表中对21例髋臼骨溶解进行回顾性分析，分析前后共2次，在髋臼置换术中F≤25％，25 ％<F≤50％，50％<F≤75％或F> 75％。进行体积分析（容积分析），并使用感兴趣区域勾画出骨溶解和骨水泥的轮廓。使用Fleiss'Kappa检验对4级量表和简化的2级量表（F≤50％和F> 50％）评估了F主观者之间的观察者一致性。然后使用准确性和误差计算作为4个等级的等级和准确性，敏感性，特异性，阳性预测值和阴性预测值的参考，针对每个读者评估F主观性与Fvolumetric（被认为是金标准）的性能。年级量表。结果对于4级量表分析，Interobserver一致性被认为非常低（<0.2），对于2级量表分析，Interobserver一致性被认为低（> 0.2和<0.4），kappa系数分别为0.196和0.36。与体积分析相比，4级和2级量表的总体准确度分别为36.5％和60％。结论对髋臼溶骨性病变的骨水泥充填进行主观评价与观察者之间的一致性差，与体积分析相比，该百分比的估计过高。