Interobserver Agreement for the Detection of Barrett’s Esophagus with Optical Frequency Domain Imaging
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Optical frequency domain imaging (OFDI) is a second-generation form of optical coherence tomography (OCT) providing comprehensive cross-sectional views of the distal esophagus at a resolution of ~7 μm.
Using validated OCT criteria for squamous mucosa, gastric cardia mucosa, and Barrett’s esophagus (BE), the objective of this study was to determine the inter- and intra-observer agreements by a large number of OFDI readers for differentiating these tissues.
OFDI images were obtained from nine subjects undergoing screening and surveillance for BE. Sixty-four OFDI image regions of interest were randomly selected for review. A training set of 19 images was compiled distinguishing squamous mucosa from gastric cardia and BE using previously validated OCT criteria. The ten readers then interpreted images in a test set of 45 different images of squamous mucosa (n = 15), gastric cardia (n = 15), or BE (n = 15). Interobserver agreement differentiating the three tissue types and BE versus non-BE mucosa was determined using multi-rater Fleiss’s κ value. The images were later randomized again and four readers repeated the test 3 weeks later to assess intraobserver reliability.
All ten readers showed excellent agreement for the differentiation of BE versus non-BE mucosa (κ = 0.811 p < 0.0001) and for differentiating BE versus gastric cardia versus squamous mucosa (κ = 0.866, p < 0.0001). For the four readers who repeated the test, the median intraobserver agreement (BE vs. non-BE) was high (κ = 0.975, IQR: 0.94, 1.0).
Trained readers have a high interobserver agreement for differentiating BE, squamous, and gastric cardia mucosa using OFDI.
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- Interobserver Agreement for the Detection of Barrett’s Esophagus with Optical Frequency Domain Imaging
Digestive Diseases and Sciences
Volume 58, Issue 8 , pp 2261-2265
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Barrett’s esophagus
- Optical coherence tomography
- Upper endoscopy GI tract
- Industry Sectors
- Jenny Sauk (1) (2)
- Emmanuel Coron (3)
- Lauren Kava (1)
- Melissa Suter (1)
- Michalina Gora (1)
- Kevin Gallagher (1)
- Mireille Rosenberg (1)
- Ashwin Ananthakrishnan (2)
- Norman Nishioka (2)
- Gregory Lauwers (4)
- Kevin Woods (1) (2) (5)
- William Brugge (2)
- David Forcione (2)
- Brett E. Bouma (1)
- Guillermo Tearney (1) (4)
- Author Affiliations
- 1. Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, 40 Blossom Street, Boston, MA, 02114, USA
- 2. Gastroenterology Division, Massachusetts General Hospital, Boston, MA, USA
- 3. Department of Gastroenterology and Hepatology, Digestive Diseases Institute, University Hospital, Nantes Cedex, France
- 4. Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, WRN 2, Boston, MA, 02114-2696, USA
- 5. Digestive Diseases, Interventional Endoscopy, Emory University School of Medicine, The Emory Clinic, Inc., 1365 Clifton Road NE, Clinic B, Suite 1200, Atlanta, GA, 30322, USA