Jamjoom, AAB;
Sluijters, OJJ;
Wildman, J;
Giampiccolo, D;
Charalambides, C;
Barua, NU;
(2025)
Inter-observer agreement in interpreting intraoperative ultrasonography during brain tumour surgery.
Frontiers in Surgery
, 12
, Article 1679617. 10.3389/fsurg.2025.1679617.
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Abstract
BACKGROUND: Intraoperative ultrasonography (iUS) is a powerful technology that is being increasingly utilized for brain tumour surgery. However, ultrasonography has been documented to be observer dependent in a range of healthcare settings. Here we objectively assess the degree of inter-observer variability in iUS for brain tumour surgery. METHODS: Nine images taken from routinely collected iUS videos from brain tumour surgery were presented to 18 neurosurgeons (5 consultants, 7 senior fellows, 6 residents). This included three tumour types [metastasis, high-grade (HGG) and low-grade glioma (LGG)] at three operative stages (before, during and near resection completion). Using 3D Slicer, observers segmented what they deemed to be tumour. Digital Image Correlation Engine Similarity Coefficients (DSC) were calculated to examine inter-observer variability. RESULTS: A total of 1,377 DSCs were calculated between 18 observers across 9 images. Metastasis had the highest DSC (0.72 ± 0.32), followed by HGG (0.64 ± 0.33) and LGG (0.58 ± 0.25; p < 0.00001). As the resection progressed, the degree of inter-observer agreement broke down. Before resection the DSC was 0.87 ± 0.11; during resection (0.74 ± 0.17) and at completion (0.32 ± 0.27; p < 0.00001). The trend of decreasing agreement as the resection progressed held across tumour types. Observers reported increasing difficulty with iUS interpretation as the resection proceeded and there was statistically significant (p = 0.014) negative correlation (−0.775) between DSC and difficulty rating of the segmentation. CONCLUSION: Here we demonstrate significant inter-observer variability in iUS for brain tumour surgery. The degree of variability is tumour-type and operative stage dependent. This work adds weight to the value of building machine learning augmented iUS for brain tumour surgery.
| Type: | Article |
|---|---|
| Title: | Inter-observer agreement in interpreting intraoperative ultrasonography during brain tumour surgery |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fsurg.2025.1679617 |
| Publisher version: | https://doi.org/10.3389/fsurg.2025.1679617 |
| Language: | English |
| Additional information: | © 2025 Jamjoom, Sluijters, Wildman, Giampiccolo, Charalambides and Barua. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | intra-operative ultrasonography, brain tumour surgery, observer agreement, machine learning, glioma |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10218017 |
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