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Inter-Rater Agreement for Diagnosing Adenomyosis Using Magnetic Resonance Imaging and Transvaginal Ultrasonography

Andersson, Johanna K. ; Mucelli, Raffaella Pozzi ; Dueholm, Margit ; Fridsten, Susanne ; Grigoriadis, Aristeidis ; Guerriero, Stefano ; Leone, Francesco Paolo ; Valentin, Lil LU orcid ; Van Den Bosch, Thierry and Voulgarakis, Nikolaos , et al. (2023) In Diagnostics 13(13).
Abstract

Our aim was to compare the inter-rater agreement about transvaginal ultrasonography (TVS) with magnetic resonance imaging (MRI) with regard to diagnosing adenomyosis and for assessing various predefined imaging features of adenomyosis, in the same set of women. The study cohort included 51 women, prospectively, consecutively recruited based on a clinical suspicion of adenomyosis. MRIs and TVS videoclips and 3D volumes were retrospectively assessed by four experienced radiologists and five experienced sonographers, respectively. Each rater subjectively evaluated the presence or absence of adenomyosis, as well as imaging features suggestive of adenomyosis. Fleiss kappa (κ) was used to reflect inter-rater agreement for categorical data,... (More)

Our aim was to compare the inter-rater agreement about transvaginal ultrasonography (TVS) with magnetic resonance imaging (MRI) with regard to diagnosing adenomyosis and for assessing various predefined imaging features of adenomyosis, in the same set of women. The study cohort included 51 women, prospectively, consecutively recruited based on a clinical suspicion of adenomyosis. MRIs and TVS videoclips and 3D volumes were retrospectively assessed by four experienced radiologists and five experienced sonographers, respectively. Each rater subjectively evaluated the presence or absence of adenomyosis, as well as imaging features suggestive of adenomyosis. Fleiss kappa (κ) was used to reflect inter-rater agreement for categorical data, and the intraclass correlation coefficient (ICC) was used to reflect the reliability of quantitative data. Agreement between raters for diagnosing adenomyosis was higher for TVS than for MRI (κ = 0.42 vs. 0.28). MRI had a higher inter-rater agreement in assessing wall asymmetry, irregular junctional zone (JZ), and the presence of myometrial cysts, while TVU had a better agreement for assessing globular shape. MRI showed a moderate to good reliability for measuring the JZ (ICC = 0.57–0.82). For TVS, the JZ was unmeasurable in >50% of cases, and the remaining cases had low reliability (ICC = −0.31–0.08). We found that inter-rater agreement for diagnosing adenomyosis was higher for TVS than for MRI, despite the fact that MRI showed a higher inter-rater agreement in most specific features. Measurements of JZ in the coronal plane with 3D TVS were unreliable and thus unlikely to be useful for diagnosing adenomyosis.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adenomyosis, inter-rater agreement, magnetic resonance imaging, ultrasonography
in
Diagnostics
volume
13
issue
13
article number
2193
publisher
MDPI AG
external identifiers
  • pmid:37443587
  • scopus:85164707558
ISSN
2075-4418
DOI
10.3390/diagnostics13132193
language
English
LU publication?
yes
id
ee48b42e-815f-4a3d-a840-64a9c1417799
date added to LUP
2023-09-13 12:21:51
date last changed
2024-04-20 03:12:32
@article{ee48b42e-815f-4a3d-a840-64a9c1417799,
  abstract     = {{<p>Our aim was to compare the inter-rater agreement about transvaginal ultrasonography (TVS) with magnetic resonance imaging (MRI) with regard to diagnosing adenomyosis and for assessing various predefined imaging features of adenomyosis, in the same set of women. The study cohort included 51 women, prospectively, consecutively recruited based on a clinical suspicion of adenomyosis. MRIs and TVS videoclips and 3D volumes were retrospectively assessed by four experienced radiologists and five experienced sonographers, respectively. Each rater subjectively evaluated the presence or absence of adenomyosis, as well as imaging features suggestive of adenomyosis. Fleiss kappa (κ) was used to reflect inter-rater agreement for categorical data, and the intraclass correlation coefficient (ICC) was used to reflect the reliability of quantitative data. Agreement between raters for diagnosing adenomyosis was higher for TVS than for MRI (κ = 0.42 vs. 0.28). MRI had a higher inter-rater agreement in assessing wall asymmetry, irregular junctional zone (JZ), and the presence of myometrial cysts, while TVU had a better agreement for assessing globular shape. MRI showed a moderate to good reliability for measuring the JZ (ICC = 0.57–0.82). For TVS, the JZ was unmeasurable in &gt;50% of cases, and the remaining cases had low reliability (ICC = −0.31–0.08). We found that inter-rater agreement for diagnosing adenomyosis was higher for TVS than for MRI, despite the fact that MRI showed a higher inter-rater agreement in most specific features. Measurements of JZ in the coronal plane with 3D TVS were unreliable and thus unlikely to be useful for diagnosing adenomyosis.</p>}},
  author       = {{Andersson, Johanna K. and Mucelli, Raffaella Pozzi and Dueholm, Margit and Fridsten, Susanne and Grigoriadis, Aristeidis and Guerriero, Stefano and Leone, Francesco Paolo and Valentin, Lil and Van Den Bosch, Thierry and Voulgarakis, Nikolaos and Gemzell-Danielsson, Kristina and Epstein, Elisabeth}},
  issn         = {{2075-4418}},
  keywords     = {{adenomyosis; inter-rater agreement; magnetic resonance imaging; ultrasonography}},
  language     = {{eng}},
  number       = {{13}},
  publisher    = {{MDPI AG}},
  series       = {{Diagnostics}},
  title        = {{Inter-Rater Agreement for Diagnosing Adenomyosis Using Magnetic Resonance Imaging and Transvaginal Ultrasonography}},
  url          = {{http://dx.doi.org/10.3390/diagnostics13132193}},
  doi          = {{10.3390/diagnostics13132193}},
  volume       = {{13}},
  year         = {{2023}},
}