Agreement on Lesion Presence and Location at Colposcopy.

Autor:	Lycke KD, Kalpathy-Cramer J; Department of Radiology, Harvard Medical School, Boston, MA., Jeronimo J; National Cancer Institute, Rockville, MD., de Sanjose S, Egemen D; National Cancer Institute, Rockville, MD., Del Pino M, Marcus J; Feinberg School of Medicine at Northwestern University, Chicago, IL., Schiffman M; National Cancer Institute, Rockville, MD., Hammer A
Jazyk:	angličtina
Zdroj:	Journal of lower genital tract disease [J Low Genit Tract Dis] 2024 Jan 01; Vol. 28 (1), pp. 37-42. Date of Electronic Publication: 2023 Nov 13.
DOI:	10.1097/LGT.0000000000000786
Abstrakt:	Objectives/purpose: The reproducibility and sensitivity of image-based colposcopy is low, but agreement on lesion presence and location remains to be explored. Here, we investigate the interobserver agreement on lesions on colposcopic images by evaluating and comparing marked lesions on digitized colposcopic images between colposcopists. Methods: Five colposcopists reviewed images from 268 colposcopic examinations. Cases were selected based on histologic diagnosis, i.e., normal/cervical intraepithelial neoplasia (CIN)1 ( n = 50), CIN2 ( n = 50), CIN3 ( n = 100), adenocarcinoma in situ ( n = 53), and cancer ( n = 15). We obtained digitized time-series images every 7-10 seconds from before acetic acid application to 2 minutes after application. Colposcopists were instructed to digitally annotate all areas with acetowhitening or suspect of lesions. To estimate the agreement on lesion presence and location, we assessed the proportion of images with annotations and the proportion of images with overlapping annotated area by at least 4 (4+) colposcopists, respectively. Results: We included images from 241 examinations (1 image from each) with adequate annotations. The proportion with a least 1 lesion annotated by 4+ colposcopists increased by severity of histologic diagnosis. Among the CIN3 cases, 84% had at least 1 lesion annotated by 4+ colposcopists, whereas 54% of normal/CIN1 cases had a lesion annotated. Notably, the proportion was 70% for adenocarcinoma in situ and 71% for cancer. Regarding lesion location, there was no linear association with severity of histologic diagnosis. Conclusion: Despite that 80% of the CIN2 and CIN3 cases were annotated by 4+ colposcopists, we did not find increasing agreement on lesion location with histology severity. This underlines the subjective nature of colposcopy. Competing Interests: The authors have declared they have no conflicts of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.)
Databáze:	MEDLINE
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