{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:09:22Z","timestamp":1782389362927,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T00:00:00Z","timestamp":1427846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess interobserver reproducibility among ultrasound experts and gynecologists in the prediction by transvaginal ultrasound of deep myometrial and cervical stromal invasion in women with endometrial cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sonographic videoclips of the uterine corpus and cervix of 53 women with endometrial cancer, examined preoperatively by the same ultrasound expert, were integrated into a digitalized survey. Nine ultrasound experts and nine gynecologists evaluated presence or absence of deep myometrial and cervical stromal invasion. Histopathology from hysterectomy specimens was used as the gold standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with gynecologists, ultrasound experts showed higher sensitivity, specificity and agreement with histopathology in the assessment of cervical stromal invasion (42% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 31\u201353%) <jats:italic>vs<\/jats:italic> 57% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 45\u201368%), <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01; 83% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 78\u201386%) <jats:italic>vs<\/jats:italic> 87% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 83\u201390%), <jats:italic>P<\/jats:italic>\u2009=\u20090.02; and kappa, 0.45 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.40\u20130.49) <jats:italic>vs<\/jats:italic> 0.58 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.53\u20130.62), <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001, respectively) but not of deep myometrial invasion (73% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 66\u201379%) <jats:italic>vs<\/jats:italic> 73% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 66\u201379%), <jats:italic>P<\/jats:italic>\u2009=\u20091.0; 70% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 65\u201375%) <jats:italic>vs<\/jats:italic> 69% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 63\u201374%), <jats:italic>P<\/jats:italic>\u2009=\u20090.68; and kappa, 0.48 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.44\u20130.53) <jats:italic>vs<\/jats:italic> 0.52 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.48\u20130.57), <jats:italic>P<\/jats:italic>\u2009=\u20090.11, respectively). Though interobserver reproducibility (in the context of test proportions \u2018good\u2019 and \u2018very good\u2019, according to kappa) regarding deep myometrial invasion did not differ between the groups (experts, 34% <jats:italic>vs<\/jats:italic> gynecologists, 22%, <jats:italic>P<\/jats:italic>\u2009=\u20090.13), ultrasound experts assessed cervical stromal invasion with significantly greater interobserver reproducibility than did gynecologists (53% <jats:italic>vs<\/jats:italic> 14%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative ultrasound assessment of deep myometrial and cervical stromal invasion in endometrial cancer is best performed by ultrasound experts, as, compared with gynecologists, they showed a greater degree of agreement with histopathology and greater interobserver reproducibility in the assessment of cervical stromal invasion. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14645","type":"journal-article","created":{"date-parts":[[2014,8,4]],"date-time":"2014-08-04T12:37:20Z","timestamp":1407155840000},"page":"476-482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Transvaginal ultrasound assessment of myometrial and cervical stromal invasion in women with endometrial cancer: interobserver reproducibility among ultrasound experts and gynecologists"],"prefix":"10.1002","volume":"45","author":[{"given":"L. S. E.","family":"Eriksson","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-8235","authenticated-orcid":false,"given":"P. G.","family":"Lindqvist","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology CLINTEC Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Fl\u00f6ter R\u00e5destad","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Dueholm","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Fischerova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology First Faculty of Medicine and General University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Franchi","sequence":"additional","affiliation":[{"name":"Gynecologic Preventive Unit, Division of Gynecology IEO  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Jokubkiene","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Skane University Hospital  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. P.","family":"Leone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital L. Sacco  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Savelli","sequence":"additional","affiliation":[{"name":"Gynecology and Early Pregnancy Ultrasound Unit S. Orsola\u2010Malpighi Hospital  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Sladkevicius","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Skane University Hospital  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Testa","sequence":"additional","affiliation":[{"name":"Department of Oncology Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Van den Bosch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology KU Leuven, University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ameye","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration KU Leuven, University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007794.pub2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(06)60031-3"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn397"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61766-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12103"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13216"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5295"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443610903521890"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/IGC.0b013e3181ad3eb6"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.11.025"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12499"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1699-0463.1995.tb01399.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182073ac0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-012-2400-y"},{"key":"e_1_2_6_16_1","first-page":"360","article-title":"Understanding interobserver agreement: the kappa statistic","volume":"37","author":"Viera AJ","year":"2005","journal-title":"Fam Med"},{"key":"e_1_2_6_17_1","first-page":"293","article-title":"The value of ultrasonography in preoperative assessment of selected prognostic factors in endometrial cancer","volume":"24","author":"Sawicki W","year":"2003","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_6_18_1","first-page":"128","article-title":"The value of transvaginal sonography in the preoperative assessment of myometrial invasion in high and low grade endometrial cancer and in comparison to frozen section in grade 1 disease","volume":"21","author":"Fishman A","year":"2000","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_6_19_1","first-page":"209","article-title":"Assessment of myometrial and cervical invasion of endometrial cancer by transvaginal sonography","volume":"22","author":"Szantho A","year":"2001","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.05.041"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.06.022"},{"key":"e_1_2_6_22_1","first-page":"47","article-title":"Accuracy of transvaginal ultrasound for the evaluation of myometrial invasion in endometrial carcinoma","volume":"87","author":"Ruangvutilert P","year":"2004","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13248"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.02.012"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.14645","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.14645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T18:24:01Z","timestamp":1696530241000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.14645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1002\/uog.14645"],"URL":"https:\/\/doi.org\/10.1002\/uog.14645","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4]]},"assertion":[{"value":"2014-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}