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Canadian Association of Radiologists Journal
Sage Publications Inc
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Abstract: |
Purpose: To assess and compare intrareader and interreader reproducibility of MRI
diagnosis of female genital anomalies (FGAs) using the American Society for
Reproductive Medicine-Mullerian anomalies classification 2021 (ASRM-MAC 2021)
and European Society of Human Reproduction and Embryology-European Society for
Gynecological Endoscopy (ESHREESGE) 2016 classification.
Methods: In this retrospective study, we searched our electronic MRI database from
April 2021 to September 2023, selecting MRI studies with FGAs. Seventy-six
consecutive studies were included and reviewed by 4 independent radiologists using
both classifications. Studies were re-evaluated after 1 month. Reproducibility was
assessed using kappa (κ) scores with 95% confidence intervals (CI).
Results: Intrareader agreement for MRI diagnosis of FGAs was substantial to
excellent, with κ scores ranging from 0.684 (95% CI, 0.534-0.834) to 0.985 (95% CI,
0.963-1.01) using the ASRM-MAC 2021 and from 0.743 (95% CI, 0.621-0.865) to
0.846 (95% CI, 0.719-0.973) using the ESHRE-ESGE 2016 classification. Pairwise
interreader agreement was higher with the ASRM-MAC 2021, ranging from moderate
(κ = 0.491; 95% CI, 0.341-0.642) to substantial (κ = 0.709; 95% CI, 0.597-0.821),
compared to the ESHRE-ESGE 2016 classification, with weak (κ = 0.080; 95% CI,
0.068-0.228) to moderate (κ = 0.511; 95% CI, 0.344-0.678) agreement. Overall
interreader agreement was moderate for both classifications (κ = 0.599; 95% CI, 0.562-
0.638 for ASRM-MAC 2021 and κ = 0.429; 95% CI, 0.396-0.463 for ESHRE-ESGE
2016 classification), but with significant differences (non-overlapping CIs).Conclusion: The intrareader reproducibility was high for both classifications, whereas
the interreader reproducibility was higher using the ASRM-MAC 2021, highlighting
the impact of classification criteria on the reproducibility of MRI diagnosis of FGAs.
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