Contrast-enhanced ultrasound in association with serum biomarkers for differentiating combined hepatocellular-cholangiocarcinoma from hepatocellular carcinoma and intrahepatic cholangiocarcinoma

Table 3 The inter-observer agreement of contrasted-enhanced ultrasound features for the combined hepatocellular-cholangiocarcinomas and non-combined hepatocellular-cholangiocarcinomas lesions

	CHC		K1	Non-CHC		K2
	Reader 1	Reader 2		Reader 1	Reader 2
APHE pattern			0.624			0.524
Rim-like	6	3		8	3
Non-rim-like	29	32		91	96
Timing of washout onset			0.608			0.875
Early, < 60 s	26	22		42	40
Late, > 60 s	9	13		57	59
Degree of washout			0.635			0.662
Marked, as observed within first 120 s	3	3		2	1
Mild	32	32		97	98
CEUS LI-RADS			0.663			0.876
LR-5	9	12		56	58
LR-M	26	23		43	41

Kappa values 0.81-1.0, 0.61-0.80, 0.41-0.60, 0.21-0.40, and 0.00-0.20 correspond to almost perfect, substantial, moderate, fair, and slight, respectively. APHE: Arterial Phase Hyperenhancement; CEUS: Contrasted-enhanced ultrasound; CHC: Combined hepatocellular-cholangiocarcinoma; LI-RADS: Liver Imaging Reporting and Data system.