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Canadian Association of Radiologists Journal J
Sage
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| Abstract: |
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 (ESHRE-ESGE) 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 four independent radiologists using both classifications. Studies were re-evaluated after
one 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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