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Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience

Background and objectives: An expert’s subjective assessment is still the most reliable evaluation of adnexal pathology, thus raising the need for methods less dependent on the examiner’s experience. The aim of this study was to evaluate the performance of standardized methods when applied by examin...

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Autores principales: Tavoraitė, Indrė, Kronlachner, Laura, Opolskienė, Gina, Bartkevičienė, Daiva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304887/
https://www.ncbi.nlm.nih.gov/pubmed/34356989
http://dx.doi.org/10.3390/medicina57070708
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author Tavoraitė, Indrė
Kronlachner, Laura
Opolskienė, Gina
Bartkevičienė, Daiva
author_facet Tavoraitė, Indrė
Kronlachner, Laura
Opolskienė, Gina
Bartkevičienė, Daiva
author_sort Tavoraitė, Indrė
collection PubMed
description Background and objectives: An expert’s subjective assessment is still the most reliable evaluation of adnexal pathology, thus raising the need for methods less dependent on the examiner’s experience. The aim of this study was to evaluate the performance of standardized methods when applied by examiners with different levels of experience and to suggest the most suitable method for less-experienced gynecologists. Materials and methods: This single-center retrospective study included 50 cases of histologically proven first-time benign or malignant adnexal pathology. Three examiners evaluated the same transvaginal ultrasound images: an expert (level III), a 4th year resident in gynecology (level I), and a final year medical student after basic training (labeled as level 0). The assessment methods included subjective evaluation, Simple Rules (SR) with and without algorithm, ADNEX and Gynecologic Imaging Reporting and Data System (GI-RADS) models. Sensitivity, specificity, accuracy, positive and negative predictive values with 95% confidence interval were calculated. Results: Out of 50 cases, 33 (66%) were benign and 17 (34%) were malignant adnexal masses. Using only SR, level III could classify 48 (96%), level I—41 (82%) and level 0—40 (80%) adnexal lesions. Using SR and algorithm, the performance improved the most for all levels and yielded sensitivity and specificity of 100% for level III, 100% and 97% for level I, 94.4% and 100% for level 0, respectively. Compared to subjective assessment, ADNEX lowered the accuracy of level III evaluation from 97.9% to 88% and GI-RADS had no impact. ADNEX and GI-RADS improved the sensitivity up to 100% for the less experienced; however, the specificity and accuracy were notably decreased. Conclusions: SR and SR+ algorithm have the most potential to improve not only sensitivity, but also specificity and accuracy, irrespective of the experience level. ADNEX and GI-RADS can yield sensitivity of 100%; however, the accuracy is decreased.
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spelling pubmed-83048872021-07-25 Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience Tavoraitė, Indrė Kronlachner, Laura Opolskienė, Gina Bartkevičienė, Daiva Medicina (Kaunas) Article Background and objectives: An expert’s subjective assessment is still the most reliable evaluation of adnexal pathology, thus raising the need for methods less dependent on the examiner’s experience. The aim of this study was to evaluate the performance of standardized methods when applied by examiners with different levels of experience and to suggest the most suitable method for less-experienced gynecologists. Materials and methods: This single-center retrospective study included 50 cases of histologically proven first-time benign or malignant adnexal pathology. Three examiners evaluated the same transvaginal ultrasound images: an expert (level III), a 4th year resident in gynecology (level I), and a final year medical student after basic training (labeled as level 0). The assessment methods included subjective evaluation, Simple Rules (SR) with and without algorithm, ADNEX and Gynecologic Imaging Reporting and Data System (GI-RADS) models. Sensitivity, specificity, accuracy, positive and negative predictive values with 95% confidence interval were calculated. Results: Out of 50 cases, 33 (66%) were benign and 17 (34%) were malignant adnexal masses. Using only SR, level III could classify 48 (96%), level I—41 (82%) and level 0—40 (80%) adnexal lesions. Using SR and algorithm, the performance improved the most for all levels and yielded sensitivity and specificity of 100% for level III, 100% and 97% for level I, 94.4% and 100% for level 0, respectively. Compared to subjective assessment, ADNEX lowered the accuracy of level III evaluation from 97.9% to 88% and GI-RADS had no impact. ADNEX and GI-RADS improved the sensitivity up to 100% for the less experienced; however, the specificity and accuracy were notably decreased. Conclusions: SR and SR+ algorithm have the most potential to improve not only sensitivity, but also specificity and accuracy, irrespective of the experience level. ADNEX and GI-RADS can yield sensitivity of 100%; however, the accuracy is decreased. MDPI 2021-07-13 /pmc/articles/PMC8304887/ /pubmed/34356989 http://dx.doi.org/10.3390/medicina57070708 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tavoraitė, Indrė
Kronlachner, Laura
Opolskienė, Gina
Bartkevičienė, Daiva
Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience
title Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience
title_full Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience
title_fullStr Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience
title_full_unstemmed Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience
title_short Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience
title_sort ultrasound assessment of adnexal pathology: standardized methods and different levels of experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304887/
https://www.ncbi.nlm.nih.gov/pubmed/34356989
http://dx.doi.org/10.3390/medicina57070708
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