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Interobserver agreement for the detection of Barrett's esophagus with optical frequency domain imaging

, : Interobserver agreement for the detection of Barrett's esophagus with optical frequency domain imaging. Digestive Diseases and Sciences 58(8): 2261-2265

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 ?m.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 ? 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 (? = 0.811 p < 0.0001) and for differentiating BE versus gastric cardia versus squamous mucosa (? = 0.866, p < 0.0001). For the four readers who repeated the test, the median intraobserver agreement (BE vs. non-BE) was high (? = 0.975, IQR: 0.94, 1.0).Trained readers have a high interobserver agreement for differentiating BE, squamous, and gastric cardia mucosa using OFDI.


PMID: 23508980

DOI: 10.1007/s10620-013-2625-x

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