使用各种超声诊断模型对附件肿块的主观评估:观察者间变异性的分析。

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Ivana Rizzuto, Shohreh Rezai, Annah Lane, Marita Prior, Kristy P Robledo, Andreas Obermair
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引用次数: 0

摘要

目的:在澳大利亚以人群为基础的背景下,研究国际卵巢肿瘤分析(IOTA)基于超声的简单规则风险(SRRisk)评分、logistic回归模型2 (LR2)、ADNEX模型中不同肿瘤的评估和卵巢-附件报告和数据系统(O-RADS)的观察者间一致性。方法:于2020年1月至2021年1月进行回顾性多中心研究。该研究包括198名患有附件肿块的女性,她们接受了经阴道灰色分级和功率多普勒超声检查。参与者是从两个三级癌症中心的多学科肿瘤学会议(MDT)中招募的。两名独立放射科医生根据SRR、LR2评分、ADNEX模型和O-RADS对附件肿块进行描述。差异bbb30个单位被认为是差异,bbb50个单位被认为是高度差异。结果:198例患者中,良性卵巢肿块128例,恶性肿瘤53例,交界性肿瘤17例。在肿瘤内血流、囊肿小囊的数量和实性突起内血流的存在方面有很强的一致性(Cohen’s kappa 0.8)。观察者间一致性中等(Cohen’s kappa 0.60-0.79),存在自由盆腔液/腹水、固体成分、单眼囊肿和声影。198例中,SRRisk高差异10例(5%),差异(38/198)19%;LR2高差异(20/198)10%,差异(36/198)18%;ADNEXA模型高差异(10/198)5%,差异(24/198)12%。比较两名观察者之间的O-RADS得分,kappa为0.65,有中等程度的一致性。在7/198(4%)病例中,当使用O-RADS评分时,观察者之间的差异为2个或更多类别。结论:我们的结果表明,在使用完善的超声诊断模型评估附件肿块时,观察者之间存在差异。超声卵巢癌风险预测模型的实施需要考虑这一问题,并确保检查人员在该技术方面有足够的培训,并制定标准操作程序以减少观察者之间的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subjective Assessment of Adnexal Masses Using Various Ultrasonographic Diagnostic Models: An Analysis of Interobserver Variability.

Objective: To investigate the interobserver agreement of the International Ovarian Tumour Analysis (IOTA) ultrasound-based simple rules risk (SRRisk) score, the logistic regression model 2 (LR2), the Assessment of Different NEoplasias in the adneXa (ADNEX) model and the Ovarian-Adnexal Reporting and Data System (O-RADS) in an Australian, population-based context.

Methods: A retrospective multi-centre study was performed between January 2020 and January 2021. The study included 198 women with adnexal masses examined with transvaginal grey scale and power Doppler ultrasound. Participants were recruited from the multidisciplinary oncology meetings (MDT) of two tertiary cancer centres. Two independent radiologists described the adnexal masses according to the SRR, LR2 scores, ADNEX model, and O-RADS. Values > 30 units different were considered differential and > 50 units were considered highly differential.

Results: From 198 patients, 128 were diagnosed with benign ovarian masses, 53 with malignant and 17 patients with borderline tumours. There was strong agreement (Cohen's kappa 0.8) for intra-tumour blood flow, number of cysts locules, and presence of blood flow within solid projections. Interobserver agreement was moderate (Cohen's kappa 0.60-0.79) for the presence of free pelvic fluid/ascites, solid components, unilocular cysts and acoustic shadows. Of the 198 cases, 10 (5%) cases were highly differential and (38/198) 19% were differential for SRRisk, (20/198) 10% highly differential and (36/198) 18% differential for LR2, and (10/198) 5% and (24/198) 12% for ADNEXA model, respectively. Comparison of O-RADS scores between the two observers showed a moderate agreement with a kappa of 0.65. In 7/198 (4%) cases, the difference between observers was for 2 or more categories when using the O-RADS score.

Conclusions: Our results suggested that interobserver variation was present in evaluating adnexal masses using well established ultrasonographic diagnostic models. Implementation of sonographic ovarian cancer risk prediction models will need to consider this issue and ensure examiners have adequate training in the technique, and standard operating procedures are in place to reduce interobserver variability.

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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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