1.International Endometrial Tumor Analysis (IETA) terminology for the evaluation of endometrial color flow and vascular pattern in women with abnormal uterine bleeding – a reproducibility study among ob-gyn ultrasound subspecialists in a tertiary training hospital
Nina Rojana Lim Yu ; Regina Rosario Panlilio-Vitriolo
Philippine Journal of Obstetrics and Gynecology 2023;47(5):260-270
Background:
The International Endometrial Tumor Analysis (IETA) group developed a catalog
of standardized terms to describe findings that may be associated with uterine pathology. However,
there is a lack of reliability studies for these descriptors in the literature.
Objective:
The objective of this study was to estimate interobserver and intraobserver reliability
with regard to the IETA group descriptors for endometrial vascular characteristics in women with
abnormal uterine bleeding.
Materials and Methods:
Five nonexpert and five expert raters assessed stored still images
of transvaginal ultrasound examinations obtained from 68 women with abnormal uterine bleeding
and endometrial thickening. Endometrial vascularity was evaluated using the IETA group descriptors
for color flow and vascular pattern. Interobserver agreement was estimated by comparing the
assessments of the nonexpert and expert raters. Intraobserver agreement was estimated by repeating
the raters’ assessment after 4 weeks. Interrater agreement to the subjective assessment of an expert
investigator was also computed.
Results and Conclusion
The reproducibility of assigning IETA color score is good regardless
of the degree of expertise of the rater, although the experts displayed better interobserver reliability
(κ = 0.74 vs. 0.57) and intraobserver reliability (κ = 0.84 vs. 0.63). However, the reproducibility
of describing IETA vascular patterns is significantly worse for both expert and nonexpert raters
in both interobserver reliability (experts κ = 0.49 vs. 0.34) and intraobserver reliability (experts
κ = 0.65 vs. 0.42). Both expert and nonexpert raters exhibited acceptable agreement with the
reference standard, with experts performing better for both color score (κ = 0.79 vs. 0.70) and
vascular pattern (κ = 0.63 vs. 0.44).
Endometrium