Department of Radiology, Stanford Hospital and Clinics, Stanford, CA, USA.
Department of Radiology, University of CA - San Francisco, San Francisco, CA, USA.
Abdom Radiol (NY). 2022 Sep;47(9):3318-3326. doi: 10.1007/s00261-022-03580-8. Epub 2022 Jun 28.
To evaluate interobserver agreement in assigning imaging features and classifying adnexal masses using the IOTA simple rules versus O-RADS lexicon and identify causes of discrepancy.
Pelvic ultrasound (US) examinations in 114 women with 118 adnexal masses were evaluated by eight radiologists blinded to the final diagnosis (4 attendings and 4 fellows) using IOTA simple rules and O-RADS lexicon. Each feature category was analyzed for interobserver agreement using intraclass correlation coefficient (ICC) for ordinal variables and free marginal kappa for nominal variables. The two-tailed significance level (a) was set at 0.05.
For IOTA simple rules, interobserver agreement was almost perfect for three malignant lesion categories (M2-4) and substantial for the remaining two (M1, M5) with k-values of 0.80-0.82 and 0.68-0.69, respectively. Interobserver agreement was almost perfect for two benign feature categories (B2, B3), substantial for two (B4, B5) and moderate for one (B1) with k-values of 0.81-0.90, 0.69-0.70 and 0.60, respectively. For O-RADS, interobserver agreement was almost perfect for two out of ten feature categories (ascites and peritoneal nodules) with k-values of 0.89 and 0.97. Interobserver agreement ranged from fair to substantial for the remaining eight feature categories with k-values of 0.39-0.61. Fellows and attendings had ICC values of 0.725 and 0.517, respectively.
O-RADS had variable interobserver agreement with overall good agreement. IOTA simple rules had more uniform interobserver agreement with overall excellent agreement. Greater reader experience did not improve interobserver agreement with O-RADS.
使用 IOTA 简单规则和 O-RADS 词汇表评估观察者间在分配成像特征和分类附件肿块方面的一致性，并确定差异的原因。
对 114 例 118 个附件肿块的盆腔超声（US）检查由 8 名放射科医生进行评估，这些医生对最终诊断（4 名主治医生和 4 名住院医师）不知情，使用 IOTA 简单规则和 O-RADS 词汇表。对于每个特征类别，使用有序变量的组内相关系数（ICC）和名义变量的自由边际kappa 分析观察者间的一致性。双侧显著性水平（a）设为 0.05。
对于 IOTA 简单规则，对于三个恶性病变类别（M2-4），观察者间的一致性几乎是完美的，对于其余两个（M1、M5），一致性也很高，kappa 值分别为 0.80-0.82 和 0.68-0.69。对于两个良性特征类别（B2、B3），观察者间的一致性几乎是完美的，对于两个（B4、B5）和一个（B1），一致性也很高，kappa 值分别为 0.81-0.90、0.69-0.70 和 0.60。对于 O-RADS，对于十个特征类别中的两个（腹水和腹膜结节），观察者间的一致性几乎是完美的，kappa 值分别为 0.89 和 0.97。对于其余八个特征类别，观察者间的一致性从公平到良好不等，kappa 值为 0.39-0.61。住院医师和主治医生的 ICC 值分别为 0.725 和 0.517。
O-RADS 的观察者间一致性存在差异，总体一致性良好。IOTA 简单规则的观察者间一致性更加统一，总体一致性极好。读者经验的增加并没有提高 O-RADS 的观察者间一致性。
