Intraobserver and Interobserver Agreement of Grayscale Typical Ultrasonographic Patterns for the Diagnosis of Ovarian Cancer

Guerriero, S.; Alcázar, Juan Luis; Pascual, M.; Ajossa, Silvia; Gerada, M.; Bargellini, Roberta; Virgilio, B.; Melis, Gian Benedetto

doi:10.1016/j.ultrasmedbio.2008.04.007

Cited by 24 publications

(30 citation statements)

References 24 publications

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“…Our results are in agreement with those of Timmerman et al [4] and those of Guerriero et al [17] , that the ability to correctly discriminate between benign and malignant adnexal masses when evaluating static ultrasound images using pattern recognition increases with the experience of the observers. Guerriero et al [17] reported how accurately endometriomas, teratomas and serous cysts could be diagnosed when ultrasound images were independently evaluated by sonologists with different levels of experience.…”

Section: Discussionsupporting

confidence: 93%

“…Guerriero et al [17] reported how accurately endometriomas, teratomas and serous cysts could be diagnosed when ultrasound images were independently evaluated by sonologists with different levels of experience. Their conclusion was the same as ours, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…However, their 'non-experts' had more experience in gynecological ultrasound than our 'non-experts', and the performance of the experts was better in our study than in theirs. This is probably explained by the fact that in the study of Guerriero et al [17] a mass could only be classified as belonging to a specific histological category if it fitted a predetermined definition (for example, an endometrioma was defined as 'round or ovoid homogeneous hypoechoic tissue with ground glass content without papillary proliferation and a clear demarcation from the ovarian parenchyma'). In our study, pattern recognition was used, giving the examiner more freedom to use his/her skills in subjective evaluation of ultrasound findings.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound Experience Substantially Impacts on Diagnostic Performance and Confidence when Adnexal Masses Are Classified Using Pattern Recognition

Holsbeke

Daemen

Yazbek

et al. 2009

Gynecol Obstet Invest

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Aim: To determine how accurately and confidently examiners with different levels of ultrasound experience can classify adnexal masses as benign or malignant and suggest a specific histological diagnosis when evaluating ultrasound images using pattern recognition. Methods: Ultrasound images of selected adnexal masses were evaluated by 3 expert sonologists, 2 senior and 4 junior trainees. They were instructed to classify the masses using pattern recognition as benign or malignant, to state the level of confidence with which this classification was made and to suggest a specific histological diagnosis. Sensitivity, specificity, accuracy and positive and negative likelihood ratios (LR+ and LR–) with regard to malignancy were calculated. The area under the receiver operating characteristic curve (AUC) of pattern recognition was calculated by using six levels of diagnostic confidence. Results: 166 masses were examined, of which 42% were malignant. Sensitivity with regard to malignancy ranged from 80 to 86% for the experts, was 70 and 84% for the 2 senior trainees and ranged from 70 to 86% for the junior trainees. The specificity of the experts ranged from 79 to 91%, was 77 and 89% for the senior trainees and ranged from 59 to 83% for the junior trainees. The experts were uncertain about their diagnosis in 4–13% of the cases, the senior trainees in 15–20% and the junior trainees in 67–100% of the cases. The AUCs ranged from 0.861 to 0.922 for the experts, were 0.842 and 0.855 for the senior trainees, and ranged from 0.726 to 0.795 for the junior trainees. The experts suggested a correct specific histological diagnosis in 69–77% of the cases. All 6 trainees did so significantly less often (22–42% of the cases). Conclusion: Expert sonologists can accurately classify adnexal masses as benign or malignant and can successfully predict the specific histological diagnosis in many cases. Whilst less experienced operators perform reasonably well when predicting the benign or malignant nature of the mass, they do so with a very low level of diagnostic confidence and are unable to state the likely histology of a mass in most cases.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasound Experience Substantially Impacts on Diagnostic Performance and Confidence when Adnexal Masses Are Classified Using Pattern Recognition

Holsbeke

Daemen

Yazbek

et al. 2009

Gynecol Obstet Invest

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“…The best diagnostic performance, in combination with the lowest interobserver variability, was achieved by the group of level III sonologists. These results are in agreement with those of other published studies assessing interobserver variability relative to different levels of experience [17,18,20,21]. The largest differences in diagnostic performance were observed in the present series in the classification of malignant tumors.…”

Section: Discussionsupporting

confidence: 93%

“…To date, only a few studies including small numbers of different observers have assessed the results of subjective evaluation by less experienced examiners [17,18,20,21]. A recent study compared diagnostic accuracy in a group of three expert sonologists and two senior and four junior trainees.…”

Section: Introductionmentioning

confidence: 99%

Subjective assessment of ovarian masses using pattern recognition: the impact of experience on diagnostic performance and interobserver variability

Faschingbauer

Benz

Häberle

et al. 2012

Arch Gynecol Obstet

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Intra‐ and interobserver variability of 2D and 3D transvaginal sonography in the diagnosis of benign versus malignant adnexal masses

Pascual

Graupera

Hereter

et al. 2011

J of Clinical Ultrasound

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Purpose:The purpose of this study was to compare the intra-observer and inter-observer agreement in assigning a diagnosis of malignancy or benignity to adnexal masses using 2-dimensional ultrasonography (2D US) and 3-dimensional ultrasonography (3D US). Methods:Two experienced observers (Observers A and B) performed a retrospective review of digitally stored 2D images and 3D data from a sample of 41 consecutive patients with a diagnosis of adnexal mass. Each observer independently, and blinded each other, evaluated the 2D static images of each adnexal mass and then the 3D volumes one-week later. The observers were required to classify the adnexal lesion as benign or malignant according to pattern recognition analysis. Intra-observer and inter-observer agreement were assessed by calculating the kappa index (κ). Results:Intra-observer agreement between 2DUS and 3DUS for the observer A was 1.00 and for the observer B was 0.69. Inter-observer agreement was 0.69 for 2D US and 1.00 for 3D US (p >0.05)Intra-observer agreement between 2DUS and 3DUS for the observer A was 0.96 and for the observer B was 0.77. Inter-observer agreement was 0.73 for 2D US and 0.92 for 3D US Conclusions:Our results indicate that 3D US for assessing adnexal masses is reproducible, but not significantly, than 2D USOur results indicate that 3D US for assessing adnexal masses is reproducible, even more than 2D US.Running Head: Three and Two-dimensional ultrasound: intra-inter-observer agreement

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Intraobserver and Interobserver Agreement of Grayscale Typical Ultrasonographic Patterns for the Diagnosis of Ovarian Cancer

Cited by 24 publications

References 24 publications

Ultrasound Experience Substantially Impacts on Diagnostic Performance and Confidence when Adnexal Masses Are Classified Using Pattern Recognition

Ultrasound Experience Substantially Impacts on Diagnostic Performance and Confidence when Adnexal Masses Are Classified Using Pattern Recognition

Subjective assessment of ovarian masses using pattern recognition: the impact of experience on diagnostic performance and interobserver variability

Intra‐ and interobserver variability of 2D and 3D transvaginal sonography in the diagnosis of benign versus malignant adnexal masses

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