Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy

R.W. Green, L. Valentin, J.L. Alcazar, V. Chiappa, B. Erdodi, D. Franchi, F. Frühauf, R. Fruscio, S. Guerriero, B. Graupera, A. Jakab, A. di Legge, M. Ludovisi, F. Mascilini, M.A. Pascual, T. van den Bosch, E. Epstein

Research output: Contribution to journalArticle

Abstract

Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). Results: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76% (range 64–93%) and for CSI median 88% (range 79–97%). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss’ kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76% (range 59–84%) with 2D-TVU and 69% (range 52–83%) for 3D-VCI; the corresponding figures for CSI were 88% (range 81–93%) and 86% (range 72–95%). Accuracy was significantly correlated to how many cases the raters assessed annually. Conclusions: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres. © 2018 Elsevier Inc.
Original languageEnglish
Pages (from-to)438-445
Number of pages8
JournalGynecologic Oncology
Volume150
Issue number3
DOIs
Publication statusPublished - 2018

Fingerprint

Neoplasm Staging
Endometrial Neoplasms
Surgical Instruments
Nonparametric Statistics
Hysterectomy
Biopsy

Keywords

  • Diagnostic imaging
  • Endometrial neoplasms
  • Neoplasm staging
  • Reproducibility of results
  • Three-dimensional imaging
  • Ultrasonography
  • adult
  • Article
  • cancer patient
  • cancer staging
  • clinical article
  • clinical evaluation
  • clinical practice
  • diagnostic accuracy
  • endometrium cancer
  • female
  • histology
  • human
  • hysterectomy
  • image quality
  • interrater reliability
  • middle aged
  • myometrial invasion
  • myometrium
  • priority journal
  • three dimensional imaging
  • three dimensional volume contrast imaging
  • transvaginal echography
  • tumor invasion
  • two dimensional transvaginal ultrasound
  • visual analog scale
  • Wilcoxon signed ranks test
  • X ray
  • aged
  • comparative study
  • diagnostic imaging
  • echography
  • endometrium tumor
  • observer variation
  • pathology
  • procedures
  • reproducibility
  • retrospective study
  • very elderly
  • contrast medium
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Endometrial Neoplasms
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Middle Aged
  • Myometrium
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Observer Variation
  • Reproducibility of Results
  • Retrospective Studies

Cite this

Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy. / Green, R.W.; Valentin, L.; Alcazar, J.L.; Chiappa, V.; Erdodi, B.; Franchi, D.; Frühauf, F.; Fruscio, R.; Guerriero, S.; Graupera, B.; Jakab, A.; di Legge, A.; Ludovisi, M.; Mascilini, F.; Pascual, M.A.; van den Bosch, T.; Epstein, E.

In: Gynecologic Oncology, Vol. 150, No. 3, 2018, p. 438-445.

Research output: Contribution to journalArticle

Green, RW, Valentin, L, Alcazar, JL, Chiappa, V, Erdodi, B, Franchi, D, Frühauf, F, Fruscio, R, Guerriero, S, Graupera, B, Jakab, A, di Legge, A, Ludovisi, M, Mascilini, F, Pascual, MA, van den Bosch, T & Epstein, E 2018, 'Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy', Gynecologic Oncology, vol. 150, no. 3, pp. 438-445. https://doi.org/10.1016/j.ygyno.2018.06.027
Green, R.W. ; Valentin, L. ; Alcazar, J.L. ; Chiappa, V. ; Erdodi, B. ; Franchi, D. ; Frühauf, F. ; Fruscio, R. ; Guerriero, S. ; Graupera, B. ; Jakab, A. ; di Legge, A. ; Ludovisi, M. ; Mascilini, F. ; Pascual, M.A. ; van den Bosch, T. ; Epstein, E. / Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy. In: Gynecologic Oncology. 2018 ; Vol. 150, No. 3. pp. 438-445.
@article{05c84dbbb5a84714bf27f69ddfa143a2,
title = "Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy",
abstract = "Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50{\%}) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). Results: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76{\%} (range 64–93{\%}) and for CSI median 88{\%} (range 79–97{\%}). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss’ kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76{\%} (range 59–84{\%}) with 2D-TVU and 69{\%} (range 52–83{\%}) for 3D-VCI; the corresponding figures for CSI were 88{\%} (range 81–93{\%}) and 86{\%} (range 72–95{\%}). Accuracy was significantly correlated to how many cases the raters assessed annually. Conclusions: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres. {\circledC} 2018 Elsevier Inc.",
keywords = "Diagnostic imaging, Endometrial neoplasms, Neoplasm staging, Reproducibility of results, Three-dimensional imaging, Ultrasonography, adult, Article, cancer patient, cancer staging, clinical article, clinical evaluation, clinical practice, diagnostic accuracy, endometrium cancer, female, histology, human, hysterectomy, image quality, interrater reliability, middle aged, myometrial invasion, myometrium, priority journal, three dimensional imaging, three dimensional volume contrast imaging, transvaginal echography, tumor invasion, two dimensional transvaginal ultrasound, visual analog scale, Wilcoxon signed ranks test, X ray, aged, comparative study, diagnostic imaging, echography, endometrium tumor, observer variation, pathology, procedures, reproducibility, retrospective study, very elderly, contrast medium, Adult, Aged, Aged, 80 and over, Contrast Media, Endometrial Neoplasms, Female, Humans, Imaging, Three-Dimensional, Middle Aged, Myometrium, Neoplasm Invasiveness, Neoplasm Staging, Observer Variation, Reproducibility of Results, Retrospective Studies",
author = "R.W. Green and L. Valentin and J.L. Alcazar and V. Chiappa and B. Erdodi and D. Franchi and F. Fr{\"u}hauf and R. Fruscio and S. Guerriero and B. Graupera and A. Jakab and {di Legge}, A. and M. Ludovisi and F. Mascilini and M.A. Pascual and {van den Bosch}, T. and E. Epstein",
note = "Export Date: 5 February 2019 CODEN: GYNOA Correspondence Address: Green, R.W.; Karolinska Institute, Department of Women's and Children's Health, Karolinska Universitetssjukhuset, Byggnad H2:00, Sweden; email: rasmus.green@ki.se Chemicals/CAS: Contrast Media Funding details: Cancer Research Foundation, CRF, 154112 Funding details: American Liver Foundation, ALF, 561101 Funding text 1: This study was supported by Swedish Governmental Grants: “Avtal om L{\"a}karutbildning och Forskning” (ALF), Stockholm County , grant no. 561101 and Cancer Research Foundation “ Radiumhemmets Forskningsfonder ”, Stockholm, Sweden, grant no. 154112 . References: Colombo, N., Creutzberg, C., Amant, F., Bosse, T., Gonz{\'a}lez-Mart{\'i}n, A., Ledermann, J., Marth, C., Sessa, C., ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up (2016) Ann. Oncol., 27, pp. 16-41; Frost, J.A., Webster, K.E., Bryant, A., Morrison, J., Lymphadenectomy for the management of endometrial cancer (2015) Cochrane Database Syst. Rev., , J. Morrison John Wiley & Sons, Ltd Chichester, UK; Eriksson, L.S.E., Lindqvist, P.G., Floter Radestad, A., Dueholm, M., Fischerova, D., Franchi, D., Jokubkiene, L., Epstein, E., Transvaginal ultrasound assessment of myometrial and cervical stromal invasion in women with endometrial cancer: interobserver reproducibility among ultrasound experts and gynecologists (2015) Ultrasound Obstet. Gynecol., 45, pp. 476-482; Armstrong, L., Fleischer, A., Andreotti, R., Three-dimensional volumetric sonography in gynecology. An overview of clinical applications (2013) Radiol. Clin. N. Am., 51, pp. 1035-1047; Wong, L., White, N., Ramkrishna, J., Araujo J{\'u}nior, E., Meagher, S., Costa, F.D.S., Three-dimensional imaging of the uterus: the value of the coronal plane (2015) World J. Radiol., 7, pp. 484-493; Alc{\'a}zar, J.L., Jurado, M., Three-dimensional ultrasound for assessing women with gynecological cancer: a systematic review (2011) Gynecol. Oncol., 120, pp. 340-346; Jantarasaengaram, S., Praditphol, N., Tansathit, T., Vipupinyo, C., Vairojanavong, K., Three-dimensional ultrasound using volume contrast imaging (VCI) display for the preoperative assessment of myometrial invasion and cervical involvement in endometrial cancer (2013) Ultrasound Obstet. Gynecol., pp. 569-574; Christensen, J.W., Dueholm, M., Hansen, E.S., Marinovskij, E., Lundorf, E., {\O}rtoft, G., Assessment of myometrial invasion in endometrial cancer using three-dimensional ultrasound and magnetic resonance imaging (2016) Acta Obstet. Gynecol. Scand., 95, pp. 55-64; Rodr{\'i}guez-Trujillo, A., Mart{\'i}nez-Serrano, M.J., Mart{\'i}nez-Rom{\'a}n, S., Mart{\'i}, C., Bu{\~n}esch, L., Nicolau, C., Pahisa, J., Preoperative assessment of myometrial invasion in endometrial cancer by 3D ultrasound and diffusion-weighted magnetic resonance imaging: a comparative study (2016) Int. J. Gynecol. Cancer, 26, pp. 1105-1110; Epstein, E., Fischerova, D., Valentin, L., Testa, A.C., Franchi, D., Sladkevicius, P., Filip, F., Van den Bosch, T., Ultrasound characteristics of endometrial cancer as defined by the International Endometrial Tumor Analysis (IETA) consensus nomenclature - a prospective multicenter study (2017) Ultrasound Obstet. Gynecol.; Haldorsen, I.S., Husby, J.A., Werner, H.M.J., Magnussen, I.J., R{\o}rvik, J., Helland, H., Trovik, J., Salvesen, H.B., Standard 1.5-T MRI of endometrial carcinomas: modest agreement between radiologists (2012) Eur. Radiol., 22, pp. 1601-1611; Cicchetti, D.V., Feinstien, A.R., High agreement but low kappa (1990) J. Clin. Epidemiol., 43, pp. 551-585; Byrt, T., Bishop, J., Carlin, J.B., Bias, prevalence and kappa (1993) J. Clin. Epidemiol., 46, pp. 423-429; DiEugenio, B., Glass, M., The kappa statistic: a second look (2004) Comput. Linguist., p. 30; Alcazar, J.L., Pineda, L., Martinez-Astorquiza Corral, T., Orozco, R., Utrilla-Layna, J., Juez, L., Jurado, M., Transvaginal/transrectal ultrasound for assessing myometrial invasion in endometrial cancer: a comparison of six different approaches (2015) J. Gynecol. Oncol., 26, pp. 201-207; Mascilini, F., Testa, A.C., Van Holsbeke, C., Ameye, L., Timmerman, D., Epstein, E., Evaluating myometrial and cervical invasion in women with endometrial cancer: comparing subjective assessment with objective measurement techniques (2013) Ultrasound Obstet. Gynecol., 42, pp. 353-358; Brennan, P., Silman, A., Statistical methods for assessing observer variability in clinical measures (1992) BMJ, 304, pp. 1491-1494; Kundel, H.L., Polansky, M., Measurement of observer agreement (2003) Radiology, 228, pp. 303-308; Al Azar, J.L., Orozco, R., Martinez-astorquiza Corral, T., Juez, L., Utrilla-layna, J., Inguez, J.A., Jurado, M., Al azar, J.L., Transvaginal ultrasound for preoperative assessment of myometrial invasion in patients with endometrial cancer: a systematic review and meta-analysis (2015) Ultrasound Obstet. Gynecol., 46, pp. 405-413; Luomaranta, A., Leminen, A., Loukovaara, M., Magnetic resonance imaging in the assessment of high-risk features of endometrial carcinoma: a meta-analysis (2015) Int. J. Gynecol. Cancer, 25, pp. 837-842; Das, S.K., Niu, X.K., Wang, J.L., Zeng, L.C., Wang, W.X., Bhetuwal, A., Yang, H.F., Usefulness of DWI in preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma: a systematic review and meta-analysis (2014) Cancer Imaging, 14, pp. 1-11; Deng, L., Wang, Q., Chen, X., Duan, X., Wang, W., Guo, Y., The combination of diffusion- and T2-weighted imaging in predicting deep myometrial invasion of endometrial cancer (2015) J. Comput. Assist. Tomogr., 39, pp. 661-673; Wu, L.M., Xu, J.R., Gu, H.Y., Hua, J., Haacke, E.M., Hu, J., Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies (2013) Eur. Radiol., 23, pp. 435-449; Epstein, E., Blomqvist, L., Imaging in endometrial cancer (2014) Best Pract. Res. Clin. Obstet. Gynaecol., 28, pp. 721-739; Savelli, L., Ceccarini, M., Ludovisi, M., Fruscella, E., de Iaco, P.A., Salizzoni, E., Mabrouk, M., Ferrandina, G., Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging (2008) Ultrasound Obstet. Gynecol., 31, pp. 560-566; Celik, C., Ozdemir, S., Kiresi, D., Emlik, D., Tazeg{\"u}l, A., Esen, H., Evaluation of cervical involvement in endometrial cancer by transvaginal sonography, magnetic resonance imaging and frozen section (2010) J. Obstet. Gynaecol., 30, pp. 302-307; Antonsen, S.L., Jensen, L.N., Loft, A., Berthelsen, A.K., Costa, J., Tabor, A., Qvist, I., H{\o}gdall, C., MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - a multicenter prospective comparative study (2013) Gynecol. Oncol., 128, pp. 300-308; Alc{\'a}zar, J.L., Gast{\'o}n, B., Navarro, B., Salas, R., Aranda, J., Guerriero, S., Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis (2017) J. Gynecol. Oncol., 28, pp. 405-413",
year = "2018",
doi = "10.1016/j.ygyno.2018.06.027",
language = "English",
volume = "150",
pages = "438--445",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "3",

}

TY - JOUR

T1 - Endometrial cancer off-line staging using two-dimensional transvaginal ultrasound and three-dimensional volume contrast imaging: Intermethod agreement, interrater reliability and diagnostic accuracy

AU - Green, R.W.

AU - Valentin, L.

AU - Alcazar, J.L.

AU - Chiappa, V.

AU - Erdodi, B.

AU - Franchi, D.

AU - Frühauf, F.

AU - Fruscio, R.

AU - Guerriero, S.

AU - Graupera, B.

AU - Jakab, A.

AU - di Legge, A.

AU - Ludovisi, M.

AU - Mascilini, F.

AU - Pascual, M.A.

AU - van den Bosch, T.

AU - Epstein, E.

N1 - Export Date: 5 February 2019 CODEN: GYNOA Correspondence Address: Green, R.W.; Karolinska Institute, Department of Women's and Children's Health, Karolinska Universitetssjukhuset, Byggnad H2:00, Sweden; email: rasmus.green@ki.se Chemicals/CAS: Contrast Media Funding details: Cancer Research Foundation, CRF, 154112 Funding details: American Liver Foundation, ALF, 561101 Funding text 1: This study was supported by Swedish Governmental Grants: “Avtal om Läkarutbildning och Forskning” (ALF), Stockholm County , grant no. 561101 and Cancer Research Foundation “ Radiumhemmets Forskningsfonder ”, Stockholm, Sweden, grant no. 154112 . References: Colombo, N., Creutzberg, C., Amant, F., Bosse, T., González-Martín, A., Ledermann, J., Marth, C., Sessa, C., ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up (2016) Ann. Oncol., 27, pp. 16-41; Frost, J.A., Webster, K.E., Bryant, A., Morrison, J., Lymphadenectomy for the management of endometrial cancer (2015) Cochrane Database Syst. Rev., , J. Morrison John Wiley & Sons, Ltd Chichester, UK; Eriksson, L.S.E., Lindqvist, P.G., Floter Radestad, A., Dueholm, M., Fischerova, D., Franchi, D., Jokubkiene, L., Epstein, E., Transvaginal ultrasound assessment of myometrial and cervical stromal invasion in women with endometrial cancer: interobserver reproducibility among ultrasound experts and gynecologists (2015) Ultrasound Obstet. Gynecol., 45, pp. 476-482; Armstrong, L., Fleischer, A., Andreotti, R., Three-dimensional volumetric sonography in gynecology. An overview of clinical applications (2013) Radiol. Clin. N. Am., 51, pp. 1035-1047; Wong, L., White, N., Ramkrishna, J., Araujo Júnior, E., Meagher, S., Costa, F.D.S., Three-dimensional imaging of the uterus: the value of the coronal plane (2015) World J. Radiol., 7, pp. 484-493; Alcázar, J.L., Jurado, M., Three-dimensional ultrasound for assessing women with gynecological cancer: a systematic review (2011) Gynecol. Oncol., 120, pp. 340-346; Jantarasaengaram, S., Praditphol, N., Tansathit, T., Vipupinyo, C., Vairojanavong, K., Three-dimensional ultrasound using volume contrast imaging (VCI) display for the preoperative assessment of myometrial invasion and cervical involvement in endometrial cancer (2013) Ultrasound Obstet. Gynecol., pp. 569-574; Christensen, J.W., Dueholm, M., Hansen, E.S., Marinovskij, E., Lundorf, E., Ørtoft, G., Assessment of myometrial invasion in endometrial cancer using three-dimensional ultrasound and magnetic resonance imaging (2016) Acta Obstet. Gynecol. Scand., 95, pp. 55-64; Rodríguez-Trujillo, A., Martínez-Serrano, M.J., Martínez-Román, S., Martí, C., Buñesch, L., Nicolau, C., Pahisa, J., Preoperative assessment of myometrial invasion in endometrial cancer by 3D ultrasound and diffusion-weighted magnetic resonance imaging: a comparative study (2016) Int. J. Gynecol. Cancer, 26, pp. 1105-1110; Epstein, E., Fischerova, D., Valentin, L., Testa, A.C., Franchi, D., Sladkevicius, P., Filip, F., Van den Bosch, T., Ultrasound characteristics of endometrial cancer as defined by the International Endometrial Tumor Analysis (IETA) consensus nomenclature - a prospective multicenter study (2017) Ultrasound Obstet. Gynecol.; Haldorsen, I.S., Husby, J.A., Werner, H.M.J., Magnussen, I.J., Rørvik, J., Helland, H., Trovik, J., Salvesen, H.B., Standard 1.5-T MRI of endometrial carcinomas: modest agreement between radiologists (2012) Eur. Radiol., 22, pp. 1601-1611; Cicchetti, D.V., Feinstien, A.R., High agreement but low kappa (1990) J. Clin. Epidemiol., 43, pp. 551-585; Byrt, T., Bishop, J., Carlin, J.B., Bias, prevalence and kappa (1993) J. Clin. Epidemiol., 46, pp. 423-429; DiEugenio, B., Glass, M., The kappa statistic: a second look (2004) Comput. Linguist., p. 30; Alcazar, J.L., Pineda, L., Martinez-Astorquiza Corral, T., Orozco, R., Utrilla-Layna, J., Juez, L., Jurado, M., Transvaginal/transrectal ultrasound for assessing myometrial invasion in endometrial cancer: a comparison of six different approaches (2015) J. Gynecol. Oncol., 26, pp. 201-207; Mascilini, F., Testa, A.C., Van Holsbeke, C., Ameye, L., Timmerman, D., Epstein, E., Evaluating myometrial and cervical invasion in women with endometrial cancer: comparing subjective assessment with objective measurement techniques (2013) Ultrasound Obstet. Gynecol., 42, pp. 353-358; Brennan, P., Silman, A., Statistical methods for assessing observer variability in clinical measures (1992) BMJ, 304, pp. 1491-1494; Kundel, H.L., Polansky, M., Measurement of observer agreement (2003) Radiology, 228, pp. 303-308; Al Azar, J.L., Orozco, R., Martinez-astorquiza Corral, T., Juez, L., Utrilla-layna, J., Inguez, J.A., Jurado, M., Al azar, J.L., Transvaginal ultrasound for preoperative assessment of myometrial invasion in patients with endometrial cancer: a systematic review and meta-analysis (2015) Ultrasound Obstet. Gynecol., 46, pp. 405-413; Luomaranta, A., Leminen, A., Loukovaara, M., Magnetic resonance imaging in the assessment of high-risk features of endometrial carcinoma: a meta-analysis (2015) Int. J. Gynecol. Cancer, 25, pp. 837-842; Das, S.K., Niu, X.K., Wang, J.L., Zeng, L.C., Wang, W.X., Bhetuwal, A., Yang, H.F., Usefulness of DWI in preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma: a systematic review and meta-analysis (2014) Cancer Imaging, 14, pp. 1-11; Deng, L., Wang, Q., Chen, X., Duan, X., Wang, W., Guo, Y., The combination of diffusion- and T2-weighted imaging in predicting deep myometrial invasion of endometrial cancer (2015) J. Comput. Assist. Tomogr., 39, pp. 661-673; Wu, L.M., Xu, J.R., Gu, H.Y., Hua, J., Haacke, E.M., Hu, J., Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies (2013) Eur. Radiol., 23, pp. 435-449; Epstein, E., Blomqvist, L., Imaging in endometrial cancer (2014) Best Pract. Res. Clin. Obstet. Gynaecol., 28, pp. 721-739; Savelli, L., Ceccarini, M., Ludovisi, M., Fruscella, E., de Iaco, P.A., Salizzoni, E., Mabrouk, M., Ferrandina, G., Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging (2008) Ultrasound Obstet. Gynecol., 31, pp. 560-566; Celik, C., Ozdemir, S., Kiresi, D., Emlik, D., Tazegül, A., Esen, H., Evaluation of cervical involvement in endometrial cancer by transvaginal sonography, magnetic resonance imaging and frozen section (2010) J. Obstet. Gynaecol., 30, pp. 302-307; Antonsen, S.L., Jensen, L.N., Loft, A., Berthelsen, A.K., Costa, J., Tabor, A., Qvist, I., Høgdall, C., MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - a multicenter prospective comparative study (2013) Gynecol. Oncol., 128, pp. 300-308; Alcázar, J.L., Gastón, B., Navarro, B., Salas, R., Aranda, J., Guerriero, S., Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis (2017) J. Gynecol. Oncol., 28, pp. 405-413

PY - 2018

Y1 - 2018

N2 - Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). Results: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76% (range 64–93%) and for CSI median 88% (range 79–97%). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss’ kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76% (range 59–84%) with 2D-TVU and 69% (range 52–83%) for 3D-VCI; the corresponding figures for CSI were 88% (range 81–93%) and 86% (range 72–95%). Accuracy was significantly correlated to how many cases the raters assessed annually. Conclusions: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres. © 2018 Elsevier Inc.

AB - Objectives: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. Methods: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). Results: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76% (range 64–93%) and for CSI median 88% (range 79–97%). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss’ kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76% (range 59–84%) with 2D-TVU and 69% (range 52–83%) for 3D-VCI; the corresponding figures for CSI were 88% (range 81–93%) and 86% (range 72–95%). Accuracy was significantly correlated to how many cases the raters assessed annually. Conclusions: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres. © 2018 Elsevier Inc.

KW - Diagnostic imaging

KW - Endometrial neoplasms

KW - Neoplasm staging

KW - Reproducibility of results

KW - Three-dimensional imaging

KW - Ultrasonography

KW - adult

KW - Article

KW - cancer patient

KW - cancer staging

KW - clinical article

KW - clinical evaluation

KW - clinical practice

KW - diagnostic accuracy

KW - endometrium cancer

KW - female

KW - histology

KW - human

KW - hysterectomy

KW - image quality

KW - interrater reliability

KW - middle aged

KW - myometrial invasion

KW - myometrium

KW - priority journal

KW - three dimensional imaging

KW - three dimensional volume contrast imaging

KW - transvaginal echography

KW - tumor invasion

KW - two dimensional transvaginal ultrasound

KW - visual analog scale

KW - Wilcoxon signed ranks test

KW - X ray

KW - aged

KW - comparative study

KW - diagnostic imaging

KW - echography

KW - endometrium tumor

KW - observer variation

KW - pathology

KW - procedures

KW - reproducibility

KW - retrospective study

KW - very elderly

KW - contrast medium

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Contrast Media

KW - Endometrial Neoplasms

KW - Female

KW - Humans

KW - Imaging, Three-Dimensional

KW - Middle Aged

KW - Myometrium

KW - Neoplasm Invasiveness

KW - Neoplasm Staging

KW - Observer Variation

KW - Reproducibility of Results

KW - Retrospective Studies

U2 - 10.1016/j.ygyno.2018.06.027

DO - 10.1016/j.ygyno.2018.06.027

M3 - Article

VL - 150

SP - 438

EP - 445

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -