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Impact of operator experience on the variability of fetal lung volume estimation by 3D-ultrasound (VOCAL) and magnetic resonance imaging in fetuses with congenital diaphragmatic hernia.
[congenital diaphragmatic hernia]
Abstract
Objective
:
To
evaluate
the
impact
of
operator
experience
in
volumetric
measurements
on
intra-
and
inter-observer
variability
of
lung
volume
estimation
by
3
-
dimensional
(
3
D
)
ultrasound
and
magnetic
resonance
imaging
(
MRI
)
in
fetuses
with
congenital
diaphragmatic
hernia
(
CDH
)
.
Methods
:
We
conducted
a
retrospective
single
-center
study
.
Total
fetal
lung
volume
(
TFLV
)
was
measured
twice
using
52
stored
3
D-
ultrasound
volumes
and
52
corresponding
MRI
exams
by
a
fetal
medicine
specialist
with
no
experience
in
volumetric
measurements
and
two
operators
experienced
in
the
respective
techniques
.
Bland-
Altman
analysis
was
performed
to
evaluate
intra-
and
inter-observer
variability
.
Results
:
Measurements
of
TFLV
by
3
D-
ultrasound
showed
higher
intra-observer
variability
compared
with
MRI
irrespective
of
operator
experience
,
with
narrower
95
%
limits
of
agreement
on
MRI
as
compared
with
ultrasound
measurements
.
Similarly
,
3
D-
ultrasound
showed
higher
inter-observer
variability
as
compared
with
MRI
.
Finally
the
95
%
limits
of
agreement
at
ultrasound
were
quite
comparable
for
intra-observer
variability
between
the
experienced
and
the
inexperienced
operator
.
Conclusion
:
Our
study
shows
that
operator
experience
has
an
impact
on
the
variability
of
TFLV
and
,
in
the
absence
of
experience
in
volumetric
measurements
,
estimation
of
TFLV
in
fetuses
with
CDH
by
3
D-
ultrasound
shows
higher
variability
than
MRI
measurements
,
but
even
in
experienced
hands
variability
is
greater
for
3
D-
ultrasound
.