Abstract
Purpose
To retrospectively compare interpretations of Doppler ultrasound (US) in newborns with confirmed perinatal testicular torsion (PTT) by an experienced faculty (staff) pediatric radiologist (SPR), pediatric radiology fellow (PRF), pediatric urology fellow (PUF) and staff pediatric urologist (SPU).
Methods
US images of 27 consecutive males with PTT between May 2000 and July 2020 were retrieved. The testicles were classified as affected or non-affected by PTT. We performed a blinded comparison of interpretation by four assessors (SPR, PRF, PUF, SPU), with respect to the US features of PTT. Paired inter-rater agreement was calculated using Cohen’s Kappa (κ) and overall agreement was assessed using Fleiss’ kappa.
Results
Overall comparison using Fleiss’ kappa found fair agreement for most features except testicular echogenicity and echogenic foci at interface for which there was poor agreement. Paired comparisons revealed better agreement between the SPR and PRF compared to the remaining two pairs, suggesting a need for the pediatric urologists (PUF and SPU) to acquaint themselves with testicular ultrasonography as this may have an impact on patient risk stratification and the quality of information given to parents.
Conclusion
This study highlights the need for focused training program for pediatric urologists to attain similar agreement as the radiologists, suggesting a need for the pediatric urologists (PUF and SPU) to acquaint themselves with testicular ultrasonography as this may have an impact on patient risk stratification and the quality of information given to parents.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TE, PY, MZ, AK and JT. The first draft of the manuscript was written by TE and PY and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This study was approved by the institutional research and ethics board (REB #1000071883).
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Yadav, P., Erlich, T., Zlotnik, M. et al. Ultrasonographical features of perinatal testicular torsion: an assessment of interobserver variability among radiologists and pediatric urologists. Pediatr Surg Int 38, 2053–2058 (2022). https://doi.org/10.1007/s00383-022-05260-6
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DOI: https://doi.org/10.1007/s00383-022-05260-6