MR Reproducibility in the Assessment of Uterine Fibroids for Patients Scheduled for Uterine Artery Embolization |
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Authors: | Nicole A Volkers Wouter J K Hehenkamp Anje M Spijkerboer Albert D Moolhuijzen Erwin Birnie Willem M Ankum Jim A Reekers |
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Institution: | (1) Department of Radiology, Academic Medical Centre, G1-235, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands;(2) Department of Gynaecology, 1105, AZ, Amsterdam, The Netherlands;(3) Department of Radiology, Waterland Hospital, Purmerend, The Netherlands;(4) Academic Medical Centre, Department of Public Health Epidemiology, Amsterdam, and Erasmus Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands |
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Abstract: | Magnetic resonance imaging (MRI) is increasingly applied in the evaluation of uterine fibroids. However, little is known about
the reproducibility of MRI in the assessment of uterine fibroids. This study evaluates the inter- and intraobserver variation
in the assessment of the uterine fibroids and concomitant adenomyosis in women scheduled for uterine artery embolization (UAE).
Forty patients (mean age: 44.5 years) with symptomatic uterine fibroids who were scheduled for UAE underwent T1- and T2-weighted MRI. To study inter- and intraobserver agreement 40 MR images were evaluated independently by two observers and
reevaluated by both observers 4 months later. Inter- and intraobserver agreement was calculated using Cohen’s κ statistic
and intraclass correlation coefficient for categorical and continuous variables, respectively. Inter-observer agreement for
uterine volumes (κ = 0.99, p < 0.0001), dominant fibroid volumes (κ = 0.98, p ≤ 0.0001), and number of fibroids (κ = 0.88; CI, 0.77–0.93; p < 0.0001) was excellent. For the T1- and T2-weighted signal intensity of the dominant fibroid there was good agreement between the observers (87%; 95% CI, 71.9%–95.6%)
and the intraobserver agreement was good for observer A (95%; 95% CI, 83.1%–99.4%) and moderate for observer B (κ = 0.47).
The interobserver agreement with respect to the presence of adenomyosis was good (κ = 0.73, p < 0.0001), while both intraobserver agreements were fair to moderate (observer A, κ = 0.55, p = 0.0003; and observer B, κ = 0.66, p < 0.0001). In conclusion, MRI criteria used for the selection of suitable UAE patients show good inter- and intraobserver
reproducibility. |
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Keywords: | Uterine artery embolization Fibroids Leiomyoma Menorrhagia Uterus Magnetic resonance imaging Adenomyosis |
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