Inter-rater Agreement for Diagnosing Adenomyosis Using Magnetic Resonance Imaging and Transvaginal Ultrasonography

Johanna Andersson, Andersson JK, Mucelli RP, Raffaella Pozzi Mucelli, Margit Dueholm, Dueholm M, Fridsten S, Susanne Fridsten, Grigoriadis A, Aristeidis Grigoriadis, S. Guerriero, Leone FP, Francesco Leone, Valentin L, L. Valentin, T. Van den Bosch, van den Bosch T, Voulgarakis N, Nikolaos Voulgarakis, Gemzell-Danielsson K, Kristina Gemzell‐Danielsson, E. Epstein, Epstein E
2023 · doi:10.20944/preprints202306.0024.v1 · W4379196686
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Transvaginal ultrasonography showed higher inter-rater agreement for diagnosing adenomyosis than MRI, though MRI had better agreement for specific features and junctional zone measurements.

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Abstract

Our aim was to compare the inter-rater agreement of Transvaginal ultrasonography (TVS) with Magnetic Resonance Imaging (MRI) regarding diagnosing adenomyosis and for various predefined imaging features of adenomyosis in the same set of women. MRIs were assessed by four experienced radiologists and 2D TVS videoclips and 3D ultrasound volumes were assessed by five experienced sonographers. Each rater subjectively evaluated the presence or absence of adenomyosis, assessed various imaging. Fleiss kappa (κ) was used to reflect inter-rater agreement for categorical data and the Intraclass correlation coefficient (ICC) to reflect the reliability of quantitative data. Agreement between raters for diagnosing adenomyosis was higher for TVS than for MRI (κ =0.42 vs.0.28). MRI had a higher inter-rater agreement in assessing wall asymmetry irregular Junctional Zone (JZ) presence of myometrial cysts, while TVU had a better agreement for globular shape. MRI showed a moderate-good reliability for measuring the JZ (ICC=0.57-0.82). For TVS, JZ was unmeasurable in > 50% of cases and the remaining cases had a low reliability (ICC=-0.31-0.08). We found that Inter-rater agreement for diagnosing adenomyosis was higher for TVS than for MRI, despite that MRI showed a higher inter-rater agreement in most specific features. Measurements of JZ in the coronal plane with 3D TVS were unreliable and thus unlikely to be useful for diagnosing adenomyosis.

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adenomyosis

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