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#743 Observer-reality agreement in assessing ovarian cancer spread and predicting non-resectability in ovarian cancer (ISAAC study, imaging study on advanced ovarian cancer)
  1. Daniela Fischerova1,
  2. Michal Pesta2,
  3. Miroslav Blasko3,
  4. Maria Cristina Moruzzi4,
  5. Kristina Hundarova5,
  6. Umberto Scovazzi6,
  7. Natacha Sousa7,
  8. Marco Ambrosio8,
  9. Antonia Carla Testa9,
  10. Dorella Franchi10,
  11. Valentina Chiappa11,
  12. Juan Luis Alcazar12,
  13. Ana Patricia Pinto13 and
  14. David Cibula1
  1. 1Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
  2. 2Faculty of Mathematics and Physics, Charles University of Prague, Prague, Czech Republic
  3. 3Department of Computer Science, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
  4. 4Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy
  5. 5Department of Gynecology, Coimbra Hospital and University Center, Coimbra, Portugal
  6. 6Hospital Polyclinic San Martino and University of Genoa, Genoa, Italy
  7. 7Department of Gynecology and Obstetrics, Hospital de Braga, Braga, Portugal
  8. 8Department of Obstetrics and Gynecology, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
  9. 9Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
  10. 10Division of Gynecology. European Institute of Oncology, Milan, Italy
  11. 11Fondazione IRCCS Istituto Nazionele dei Tumori di Milano, Milan, Italy
  12. 12Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
  13. 13Department of Gynecology, Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal


Introduction/Background To assess the interobserver-reality agreement on ovarian cancer staging, when the true-status of examined locations is known after surgery, biopsy or subsequent response to neoadjuvant treatment.

Methodology Twenty-five participants divided in two groups with variable experience in ultrasound ovarian cancer staging were included. Each observer evaluated 380 videoclips from 4 compartments (upper and middle abdomen, pelvis and lymph nodes) which included 19 anatomical sites and 5 locations markers for resectability according to ESMO-ESGO guidelines. For each clip, raters were questioned on 1) presence/absence of the disease, 2) image quality of the clip from 0 to 10, 3) level of confidence of the answer to the first question (0 to 10).

Data were evaluated using the generalized linear mixed model with random effects to assess the observer reality-agreement between the two groups, since the true-status of the disease was known.

Results The general performance of the groups was very high for all the anatomical locations (probability of match from 0.956 to 0.975) and, when compared, it was not affected by expertise (P=0.413), number of scans for ovarian cancer per-year (P=0.533) nor by number of years performing ovarian cancer staging (P=0.679). They performed similarly also in the assessment of 5 sites markers of non-resectability (P=0.779). Overall performance of both groups was significantly affected by the quality of the clips (P<0.001) and level of confidence toward the clip (P<0.001). All participants achieved higher performance in the pelvis, then middle abdomen, lymph nodes and upper abdomen respectively (joint P<0.001).

Conclusion This is the first study to demonstrate the generalizability of ultrasound for ovarian cancer staging between sonographers with variable experience. Our study results are essential for the implementing of ultrasound as alternative to other imaging techniques in ovarian cancer staging and to be a potential single imaging modality in the concept of ‘one stop’ ovarian cancer clinic.

Disclosures This work was supported by the Ministry of Health of the Czech Republic (Czech Health Research Council NV 19–03-00552).

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