Ultrasonographic diagnosis of adnexal masses: interobserver agreement in the interpretation of videos, using IOTA terminology.

Autor: Massobrio R; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy. roberta.massobrio@edu.unito.it., Mariani LL; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Conti D; SynDiag srl, c/o Innovative Enterprises Incubator of Polytechnic University of Turin, 10129, Turin, Italy., De Grandis T; Candiolo Cancer Institute, FPO-IRCCS-Candiolo, 10060, Turin, Italy., Buonomo F; Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo'', 34137, Trieste, Italy., Badellino E; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Novara L; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Bounous VE; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Perotto S; Division of Gynecologic Oncology, Michele e Pietro Ferrero Hospital, 12060, Verduno, Italy., Mancarella M; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Ferrero A; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Biglia N; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy., Fuso L; Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, University of Torino, 10128, Turin, Italy.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2024 Jan; Vol. 309 (1), pp. 211-218. Date of Electronic Publication: 2023 Oct 04.
DOI: 10.1007/s00404-023-07233-z
Abstrakt: Objectives: Aim of this study is to estimate interobserver agreement in classifying adnexal tumors using IOTA terms, simple rules and subjective assessment. In addition, we related observers' accuracy with their experience in gynecological ultrasonography and the year of IOTA certification.
Methods: Eleven observers with three different levels of experience evaluated videoclips of 70 adnexal masses, defining tumor type according to IOTA terms and definitions, classifying the mass using IOTA Simple rules and Subjective assessment as well as providing Color Score evaluation. Sensitivity, specificity and area under the ROC curve were calculated and the year of IOTA certification was related with operators' accuracy through Pearson correlation coefficient. Interobserver agreement was estimated calculating percentage of agreement, Fleiss kappa and Cohen's kappa.
Results: We found a positive correlation between the year of IOTA certification and operators' accuracy (Pearson coefficient 0.694), especially among the observers with the least experience, the residents (p = 0.003). For tumor type classification, identification of papillary projections and classification of tumors using subjective assessment, agreement among all observers was moderate (Fleiss kappa 0.455, 0.552, and 0.476, respectively) and increased with the years of experience. Agreement in the application of Simple Rules was moderate in all examiners with IOTA certification, with Fleiss kappa in the range of (0.403, 0.498). For Color Score assignment interobserver agreement among all observers was fair (Cohen's kappa 0.380).
Conclusions: Even among expert examiners, the results of adnexal lesion assessment can be inconsistent. Experience impacts on accuracy and agreement in subjective assessment, while the application of Simple Rules can mitigate the role of experience in interobserver agreement. The knowledge of IOTA models among residents seams to improve their diagnostic accuracy, showing the benefits of IOTA terminology for in training sonographers.
(© 2023. The Author(s).)
Databáze: MEDLINE
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