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Detection of intracavitary uterine pathology using offline analysis of three-dimensional ultrasound volumes: interobserver agreement and diagnostic accuracy

Van den Bosch, T.; Valentin, Lil LU ; Van Schoubroeck, D.; Luts, J.; Bignardi, T.; Condous, G.; Epstein, E.; Leone, F. P.; Testa, A. C. and Van Huffel, S., et al. (2012) In Ultrasound in Obstetrics & Gynecology 40(4). p.459-463
Abstract
Objective To estimate the diagnostic accuracy and interobserver agreement in predicting intracavitary uterine pathology at offline analysis of three-dimensional (3D) ultrasound volumes of the uterus. Methods 3D volumes (unenhanced ultrasound and gel infusion sonography with and without power Doppler, i.e. four volumes per patient) of 75 women presenting with abnormal uterine bleeding at a bleeding clinic were assessed offline by six examiners. The sonologists were asked to provide a tentative diagnosis. A histological diagnosis was obtained by hysteroscopy with biopsy or operative hysteroscopy. Proliferative, secretory or atrophic endometrium was classified as normal histology; endometrial polyps, intracavitary myomas, endometrial... (More)
Objective To estimate the diagnostic accuracy and interobserver agreement in predicting intracavitary uterine pathology at offline analysis of three-dimensional (3D) ultrasound volumes of the uterus. Methods 3D volumes (unenhanced ultrasound and gel infusion sonography with and without power Doppler, i.e. four volumes per patient) of 75 women presenting with abnormal uterine bleeding at a bleeding clinic were assessed offline by six examiners. The sonologists were asked to provide a tentative diagnosis. A histological diagnosis was obtained by hysteroscopy with biopsy or operative hysteroscopy. Proliferative, secretory or atrophic endometrium was classified as normal histology; endometrial polyps, intracavitary myomas, endometrial hyperplasia and endometrial cancer were classified as abnormal histology. The diagnostic accuracy of the six sonologists with regard to normal/abnormal histology and interobserver agreement were estimated. Results Intracavitary pathology was diagnosed at histology in 39% of patients. Agreement between the ultrasound diagnosis and the histological diagnosis (normal vs abnormal) ranged from 67 to 83% for the six sonologists. In 45% of cases all six examiners agreed with regard to the presence/absence of intracavitary pathology. The percentage agreement between any two examiners ranged from 65 to 91% (Cohen's ?, 0.310.81). The Schouten ? for all six examiners was 0.51 (95% CI, 0.400.62), while the highest Schouten ? for any three examiners was 0.69. Conclusion When analyzing stored 3D ultrasound volumes, agreement between sonologists with regard to classifying the endometrium/uterine cavity as normal or abnormal as well as the diagnostic accuracy varied substantially. Possible actions to improve interobserver agreement and diagnostic accuracy include optimization of image quality and the use of a consistent technique for analyzing the 3D volumes. Copyright (c) 2012 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
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published
subject
keywords
endometrium, reproducibility of results, ultrasonography, uterus
in
Ultrasound in Obstetrics & Gynecology
volume
40
issue
4
pages
459 - 463
publisher
John Wiley & Sons
external identifiers
  • wos:000309183800015
  • scopus:84866991555
ISSN
1469-0705
DOI
10.1002/uog.11163
language
English
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yes
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ad763de3-3bed-4ad9-8795-e66121db7e80 (old id 3283934)
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2013-01-07 09:42:24
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2017-11-12 03:49:29
@article{ad763de3-3bed-4ad9-8795-e66121db7e80,
  abstract     = {Objective To estimate the diagnostic accuracy and interobserver agreement in predicting intracavitary uterine pathology at offline analysis of three-dimensional (3D) ultrasound volumes of the uterus. Methods 3D volumes (unenhanced ultrasound and gel infusion sonography with and without power Doppler, i.e. four volumes per patient) of 75 women presenting with abnormal uterine bleeding at a bleeding clinic were assessed offline by six examiners. The sonologists were asked to provide a tentative diagnosis. A histological diagnosis was obtained by hysteroscopy with biopsy or operative hysteroscopy. Proliferative, secretory or atrophic endometrium was classified as normal histology; endometrial polyps, intracavitary myomas, endometrial hyperplasia and endometrial cancer were classified as abnormal histology. The diagnostic accuracy of the six sonologists with regard to normal/abnormal histology and interobserver agreement were estimated. Results Intracavitary pathology was diagnosed at histology in 39% of patients. Agreement between the ultrasound diagnosis and the histological diagnosis (normal vs abnormal) ranged from 67 to 83% for the six sonologists. In 45% of cases all six examiners agreed with regard to the presence/absence of intracavitary pathology. The percentage agreement between any two examiners ranged from 65 to 91% (Cohen's ?, 0.310.81). The Schouten ? for all six examiners was 0.51 (95% CI, 0.400.62), while the highest Schouten ? for any three examiners was 0.69. Conclusion When analyzing stored 3D ultrasound volumes, agreement between sonologists with regard to classifying the endometrium/uterine cavity as normal or abnormal as well as the diagnostic accuracy varied substantially. Possible actions to improve interobserver agreement and diagnostic accuracy include optimization of image quality and the use of a consistent technique for analyzing the 3D volumes. Copyright (c) 2012 ISUOG. Published by John Wiley & Sons, Ltd.},
  author       = {Van den Bosch, T. and Valentin, Lil and Van Schoubroeck, D. and Luts, J. and Bignardi, T. and Condous, G. and Epstein, E. and Leone, F. P. and Testa, A. C. and Van Huffel, S. and Bourne, T. and Timmerman, D.},
  issn         = {1469-0705},
  keyword      = {endometrium,reproducibility of results,ultrasonography,uterus},
  language     = {eng},
  number       = {4},
  pages        = {459--463},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Detection of intracavitary uterine pathology using offline analysis of three-dimensional ultrasound volumes: interobserver agreement and diagnostic accuracy},
  url          = {http://dx.doi.org/10.1002/uog.11163},
  volume       = {40},
  year         = {2012},
}