Evaluation of Sonoelastography Compatibility on the Achilles Tendon Between Different Devices and Observers

Abstract

Aim: To investigate the reliability of sonoelastography by comparing the Achilles tendon strain ratio obtained in healthy volunteers by different observers with different sonoelastography devices working on the same principle.Material and Methods: A total of 80 Achilles tendons in 40 volunteers without chronic disease were evaluated using Toshiba and Hitachi devices using real-time elastography principle. The Kager fat pad was selected for strain ratio measurement. Each tendon was evaluated with both devices twice by both observers. The intraobserver and interobserver agreement were examined by intraclass correlation coefficient (ICC) obtained by two-way mixed ANOVA model for absolute agreement and interpreted as Ko and Li (11) suggested.Results: Interobserver agreement in the first and second measurements of the Hitachi device and in the second measurements of the Toshiba device was found to be good (average ICC>0.75). The interobserver agreement in the first measurements made on the Toshiba device was found to be lower (average ICC=0.729, p<0.001). The intraobserver agreement was found to be excellent (ICC>0.90) for both device. The interobserver agreement for the Toshiba device was found lower than for the Hitachi device. Mean strain ratio was 2.96±1.07 for the Hitachi device and 3.54±1.03 for the Toshiba device. Measurements obtained from the Toshiba device were determined as significantly higher than those from the Hitachi device.Conclusion: There may be differences in strain rates depending on the compression application limits of the devices, in studies carried out using different devices. Therefore, intraobserver and interobserver agreement should be evaluated separately for each device.