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- Gaurilcikas, A., et al.
(författare)
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Early-stage cervical cancer: agreement between ultrasound and histopathological findings with regard to tumor size and extent of local disease
- 2011
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Ingår i: Ultrasound in Obstetrics & Gynecology. - : Wiley. - 1469-0705 .- 0960-7692. ; 38:6, s. 707-715
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To determine the agreement between ultrasound and histological examination of the cervix in patients with early stage cervical cancer with regard to tumor size and local extent of the disease. Methods Eighteen patients with histologically proven cervical cancer Stage IB1-IIA according to traditional clinical staging (FIGO 1988) who were scheduled for radical surgery underwent a standardized transvaginal ultrasound examination. The maximum tumor length, anteroposterior tumor diameter, tumor width, tumor area, depth of cervical stroma invasion, and the minimal thickness of tumor-free cervical stroma on sagittal and transverse planes through the cervix were measured, and the local extent of the disease within the parametria and vagina were evaluated. The surgical specimens were examined using a specifically devised method of histopathological examination. The results of the ultrasound and histopathological examinations were compared. Results Limits of agreement were wide and the intra-class correlation coefficient (ICC) was low (0.51-0.58) for three of the four measurements taken to represent the minimal depth of tumor-free cervical stroma, i.e. the results of the measurements taken posteriorly and laterally. However, the limits of agreement were narrower and the ICC values were higher (0.74-0.92) for the depth of cervical stroma invasion and for the tumor size measurements. Histological examination revealed parametrial cancer infiltration in four patients, which was detected during ultrasound examination, with no false-positive results. Conclusions Transvaginal sonography is acceptably accurate for evaluation of tumor size and depth of cervical stroma invasion in clinical practice. Copyright (C) 2011 ISUOG. Published by John Wiley & Sons, Ltd.
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| 2. |
- Pálsdóttir, K, et al.
(författare)
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Inter-observer agreement of transvaginal ultrasound and magnetic resonance imaging in local staging of cervical cancer.
- 2021
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 58:5, s. 773-779
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the inter-observer agreement in relation to observer experience for the assessment of local tumor extension in women with cervical cancer, using transvaginal ultrasound (US) and magnetic resonance imaging (MRI).METHODS: The observers comprised six US specialists with, and seven without previous experience of cervical cancer assessment, five experienced radiologists in pelvic MRI, and four less experienced radiology residents without previous MRI experience. The less experienced US observers, and all MRI observers underwent comprehensive training on assessment of cervical tumor extension while experienced US observers received written directives. All observers were assigned the same images from cervical cancer patients of all stages (n=60) for off-line evaluation on tumor detection, cervical stromal- (>1/3), and parametrial invasion. Inter-observer agreement was measured using Fleiss kappa, with 95% CI.RESULTS: Experienced and less experienced US observers had moderate agreement regarding tumor detection Fleiss κ [95% CI] (0.46 [0.40-0.53], and 0.46 [0.41-0.52]), stromal invasion (0.45 [0.38-0.51] and 0.53 [0.40-0.58]) and parametrial invasion (0.57 [0.51-0.64], and 0.44 [0.39-0.50]), respectively. Experienced and less experienced MRI observers had good κ [95% CI] (0.70 [0.62-0.78]) and moderate agreement (0.51 [0.41-0.62]), regarding tumor detection, good agreement regarding stromal invasion (0.80 [0.72-0.88] and 0.71 [0.61-0.81]) and parametrial invasion (0.69 [0.61-0.77] and 0.71[0.61-0.81]), respectively.CONCLUSION: The inter-observer agreement was moderate for US, and moderate - good for MRI regarding the assessment of local tumor extension. The level of inter-observer agreement was only associated with experience among US observers regarding parametrial invasion. This article is protected by copyright. All rights reserved.
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