Intra‐ and interobserver variability in nodule size of rectosigmoid endometriosis measured by two‐ and three‐dimensional transvaginal sonography

Egekvist, Anne Gisselmann; Forman, Axel; Riiskjær, Mads; Kesmodel, Ulrik Schiøler; Mathiasen, Mie; Seyer‐Hansen, Mikkel

doi:10.1111/aogs.13343

Cited by 6 publications

(7 citation statements)

References 32 publications

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“… 8 , 10 Two other studies used an offline approach to avoid discomfort to patients with such a usually painful disease. Reid et al 7 used videos in 30 women to evaluate only the siding sign and Egekvist et al 9 used three‐dimensional volumes and expert operators to evaluate intra‐observer and inter‐observer variability of measurement of endometriotic nodules.…”

Section: Discussionmentioning

confidence: 99%

“…The few studies about reproducibility present in the literature are related to expert operators (usually no more than 2) of the same center. [8][9][10] To the best of our knowledge, no study has reported if less expert operators can accurately replicate the results of experts. The aim of the present multicenter study was to evaluate the reproducibility of ultrasonographic (US) findings of rectosigmoid endometriosis among examiners with different level of expertise in different centers using stored 3D volumes of the posterior compartment of the pelvis as a part of SANABA (Sardinia-Navarra-Barcelona) collaborative study.…”

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confidence: 99%

“…The few studies about reproducibility present in the literature are related to expert operators (usually no more than 2) of the same center. 8 , 9 , 10 …”

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confidence: 99%

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The Reproducibility of Ultrasonographic Findings of Rectosigmoid Endometriosis Among Examiners With Different Level of Expertise

Guerriero

Pascual

Ajossa

et al. 2021

J of Ultrasound Medicine

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Objective-To analyze the reproducibility of ultrasonographic (US) findings of rectosigmoid endometriosis among examiners with different level of expertise using stored three-dimensional (3D) volumes of the posterior compartment of the pelvis as a part of SANABA (Sardinia-Navarra-Barcelona) collaborative study.Materials and methods-Six examiners in 3 academic Department of Obstetrics and Gynecology, with different levels of experience and blinded to each other, evaluated 60 stored 3D volumes from the posterior compartment of the pelvis and looked for the presence or absence of features of rectosigmoid endometriotic lesions defined as an irregular hypoechoic nodule with or without hypoechoic foci at the level of the muscularis propria of the anterior wall rectum sigma. Multiplanar view and virtual navigation were used. All examiners had to assess the 3D volume of posterior compartment of the pelvis and classify it as present or absent disease. To analyze intra-observer and the inter-observer agreements, each examiner performed the assessment twice with a 2-week interval between the first and second assessments. Reproducibility was assessed by calculating the weighted Kappa index.Results-Intra-observer reproducibility was moderate to very good for all observers (Kappa index ranging from 0.49 to 0.96) associated with a good diagnostic accuracy of each reader. Inter-observer reproducibility was fair to very good (Kappa index range: 0.21-0.87).Conclusions-The typical US sign of rectosigmoid endometriosis is reasonably recognizable to observers with different level of expertise when assessed in stored 3D volumes.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The Reproducibility of Ultrasonographic Findings of Rectosigmoid Endometriosis Among Examiners With Different Level of Expertise

Guerriero

Pascual

Ajossa

et al. 2021

J of Ultrasound Medicine

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“…A kappa index calculation was not performed between the four observers in this study, as it was a multicenter study recruiting women from three different countries, which represents a limitation. Egekvist et al 35 found intra-and interobserver variability for TVS measurements of lesion length, with a coefficient of repeatability of 11-14 mm, compared with 3-6 mm for lesion thickness and 5-9 mm for transverse diameter measurements. However, the IDEA consensus was not used.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal sonography determines accurately extent of infiltration of rectosigmoid deep endometriosis

Aas-Eng

Lieng

Dauser

et al. 2021

Ultrasound in Obstet & Gyne

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“… 11 Recent studies have shown that ultrasound measurements of the size of rectosigmoid endometriotic nodules, 12 , 13 LAVD 14 and assessment of POD obliteration 12 , 15 are accurate compared to findings at laparoscopy as a reference standard. Previous studies have assessed the intra‐ and interobserver reproducibility of TVUS in the detection and measurement of endometriotic bowel lesions 16 , 17 , 18 , 19 , 20 and POD obliteration, 15 but not for the number and depth of bowel nodules, the total length of bowel affected by endometriosis when multifocal lesions are present, nor the LAVD.…”

Section: Introductionmentioning

confidence: 99%

Intra‐ and interobserver reproducibility of transvaginal ultrasound for the detection and measurement of endometriotic lesions of the bowel

Chaggar,

Tellum,

Cohen

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionThe number and invasion depth of endometriotic bowel lesions, total length of bowel affected by endometriosis, lesion‐to‐anal verge distance, and extent of pouch of Douglas obliteration are important factors in preoperatively determining risk and complexity of endometriosis surgery. The intra‐ and interobserver reproducibility of transvaginal ultrasound in the evaluation of many of these parameters has not yet been investigated. Our study aimed to assess the intra‐ and interobserver reproducibility of transvaginal ultrasound between an experienced and less experienced examiner for all of these parameters.Material and methodsThis prospective observational cross‐sectional study was conducted between July 2019 and November 2020. Fifty consecutive premenopausal women who underwent transvaginal ultrasound examination in our clinic for the first time, were examined by the same two operators during the same attendance. Outcomes of interest were the inter‐rater reproducibility of transvaginal ultrasound for detecting the presence, number, depth and size of bowel endometriotic nodules, lesion‐to‐anal‐verge distance, total length of bowel affected, and pouch of Douglas obliteration. The intraobserver reproducibility was assessed for the continuous parameters. Cohen's kappa (κ) statistic, Cohen's weighted kappa (κ), proportions of agreement, intraclass correlation coefficient (ICC) and Bland–Altman limits of agreement were used to assess the reproducibility of the parameters.ResultsThe inter‐rater agreement and reliability were very good for identifying bowel endometriosis, the number and invasion depth of bowel nodules, determining whether the maximum nodule length was <3 cm, and lesion‐to‐anal‐verge distance <8 cm (proportion of agreement 0.92, 0.94, 0.97, 0.94, 0.96; κ 0.92, 0.91, 0.92, 0.82, 0.89). The inter‐rater agreement and reliability were good for assessing pouch of Douglas obliteration (proportion of agreement 0.86, κ 0.80). The intra‐rater reliability for the mean nodule diameter (ICC 0.93 and 0.97) and total length of bowel affected (ICC 0.94 and 0.91) were excellent for operators A and B, respectively. The inter‐rater reliability for the mean nodule diameter was good (ICC 0.80), and moderate for the total length of bowel affected (ICC 0.70). The Bland–Altman limits of agreement demonstrated clinically acceptable ranges for these two parameters.ConclusionsThis study demonstrated a high intra‐ and inter‐rater reproducibility of transvaginal ultrasound in the diagnosis of bowel endometriosis and measurement of its various components.

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Intra‐ and interobserver variability in nodule size of rectosigmoid endometriosis measured by two‐ and three‐dimensional transvaginal sonography

Abstract: Measurements of rectosigmoid endometriosis nodule size with two- and three- dimensional transvaginal sonography were associated with large intra- and interobserver variability. These techniques should therefore be used with caution in clinical control and research of nodule growth.

Cited by 6 publications

References 32 publications

The Reproducibility of Ultrasonographic Findings of Rectosigmoid Endometriosis Among Examiners With Different Level of Expertise

The Reproducibility of Ultrasonographic Findings of Rectosigmoid Endometriosis Among Examiners With Different Level of Expertise

Transvaginal sonography determines accurately extent of infiltration of rectosigmoid deep endometriosis

Intra‐ and interobserver reproducibility of transvaginal ultrasound for the detection and measurement of endometriotic lesions of the bowel

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