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Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging : Intermethod agreement, interrater reliability and diagnostic accuracy

Green, Rasmus W.; Valentin, Lil LU ; Alcazar, Juan Luis; Chiappa, Valentina; Erdodi, Balazs; Franchi, Dorella; Frühauf, Filip; Fruscio, Robert; Guerriero, Stefano and Graupera, Betlem, et al. (2018) In Gynecologic Oncology 150(3). p.438-445
Abstract

Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold... (More)

Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). Results: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76% (range 64–93%) and for CSI median 88% (range 79–97%). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss' kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76% (range 59–84%) with 2D-TVU and 69% (range 52–83%) for 3D-VCI; the corresponding figures for CSI were 88% (range 81–93%) and 86% (range 72–95%). Accuracy was significantly correlated to how many cases the raters assessed annually. Conclusions: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres.

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publication status
published
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keywords
Diagnostic imaging, Endometrial neoplasms, Neoplasm staging, Reproducibility of results, Three-dimensional imaging, Ultrasonography
in
Gynecologic Oncology
volume
150
issue
3
pages
438 - 445
publisher
Academic Press
external identifiers
  • scopus:85049904747
ISSN
0090-8258
DOI
10.1016/j.ygyno.2018.06.027
language
English
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yes
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58b8ba99-aade-4ee7-a62d-3db8411a443f
date added to LUP
2018-08-03 09:49:53
date last changed
2019-02-20 11:23:38
@article{58b8ba99-aade-4ee7-a62d-3db8411a443f,
  abstract     = {<p>Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). Results: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76% (range 64–93%) and for CSI median 88% (range 79–97%). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss' kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76% (range 59–84%) with 2D-TVU and 69% (range 52–83%) for 3D-VCI; the corresponding figures for CSI were 88% (range 81–93%) and 86% (range 72–95%). Accuracy was significantly correlated to how many cases the raters assessed annually. Conclusions: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres.</p>},
  author       = {Green, Rasmus W. and Valentin, Lil and Alcazar, Juan Luis and Chiappa, Valentina and Erdodi, Balazs and Franchi, Dorella and Frühauf, Filip and Fruscio, Robert and Guerriero, Stefano and Graupera, Betlem and Jakab, Attila and di Legge, Alessia and Ludovisi, Manuela and Mascilini, Floriana and Pascual, M. Angela and van den Bosch, Thierry and Epstein, Elisabeth},
  issn         = {0090-8258},
  keyword      = {Diagnostic imaging,Endometrial neoplasms,Neoplasm staging,Reproducibility of results,Three-dimensional imaging,Ultrasonography},
  language     = {eng},
  month        = {07},
  number       = {3},
  pages        = {438--445},
  publisher    = {Academic Press},
  series       = {Gynecologic Oncology},
  title        = {Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging : Intermethod agreement, interrater reliability and diagnostic accuracy},
  url          = {http://dx.doi.org/10.1016/j.ygyno.2018.06.027},
  volume       = {150},
  year         = {2018},
}