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OP08.03: Preoperative prediction of uterine sarcoma using T2 weighted imaging and apparent diffusion coefficient (ADC) on MRI and its clinical application
Author(s) -
Oka Y.,
Tamori M.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19455
Subject(s) - medicine , sarcoma , uterine sarcoma , myoma , effective diffusion coefficient , radiology , magnetic resonance imaging , pathological , stage (stratigraphy) , nuclear medicine , uterus , pathology , paleontology , biology
Methods: Five trainees (one staff radiologist and four 4th year OB/GYN residents) participated in this study. All trainees had experience on performing TVS, but none of them had specific training on the assessment of myometrial infiltration in cases of endometrial cancer. Training program consisted of two parts. In part one, trainees were given one specific lecture and watched video clips from ten cases explained by the trainer. The method taught for assessing myometrial infiltration was based on the subjective impression. In part two, all trainees had to visualise 50 video clips of TVS assessment of the uterus from cases of endometrial cancer already treated surgically. Definitive histology was used as reference standard. All trainees had to state whether myometrial infiltration was > 50% or < 50%. After visualising each video clip the trainee was informed whether she/he was right or wrong regarding myometrial infiltration. In case of mistake, the video clip was revised with the trainer to learn why the mistake. This feedback was considered as essential in the process of learning. All trainees performed their evaluations blinded each other. LC-CUSUM and standard CUSUM graphics were plotted to determine how many cases were needed to reach competency, allowing a mistake rate of 15% (accuracy reported for expert examiners is about 85%), and to determine whether competency is maintained after reaching competency Results: All trainees completed the study. LC-CUSUM graphics showed that four trainees reached competency at the 27th, 33th, 35th and 35th case, respectively. Three of them kept process under control after reaching competency and one did not. One trainee did not reach competency. Conclusions: Our study suggests that 30 to 35 cases would be needed to be trained for assessing myometrial infiltration by TVS by visual interpretation of video clips by most trainees.