OP03.05: Detection of Vulvar International Tumor Analysis criteria among sonographers in lymph node evaluation: interrater reliability study

Interrater reliability of Vulvar International Tumor Analysis (VITA) terms in lymph node description. The VITA steering committee collected videos of lymph nodes from patients with gynecological cancer, selected 10 videos for each of the 32 features from the 10 VITA parameters and agreed on their evaluation, setting the reference standard. After a tutorial webinar, 34 examiners from 29 centres (67.6% experienced sonographers, 70.6% from cancer centres) independently evaluated these videos on a dedicated e-platform to detect VITA parameters. Correct answer rates (%) and Fleiss kappa (k) to assess interrater agreement were calculated. Overall, the correct response rate was 87.2%. The lowest percentage correct answers was for blood vessel architecture (80.6%) (transcapsular flow 79.1%, combined flow 71.5%). Capsular interruption was the most correctly recognised parameter (95.6%). Among sub-categories, the worst results were for spiculated shape (correct answers 70.7%) and partial nodal-core sign (64.6%). Interrater agreement ranged from moderate to almost perfect (k 0.56-0.93). The main ultrasound signs of malignancy (nodal-core sign absent and round shape, cortical thickening and capsular interruption) were well recognised (90-97.3%) demonstrating almost perfect agreement (see table 1). Recognition of VITA parameters and features was good. Revision of the definitions of features with moderate agreement may improve interobserver agreement for the VITA nomenclature. Absent Present 90.0 99.7 Present Partial Present Complete 64.6 98.2 Regular Irregular 92.1 97.6 Round Oval Lobulated Spiculated 95.7 99.1 95.1 70.7 Absent Present 99.7 97.3 Focal Diffuse Concentric Eccentric 92.7 92.0 98.4 97.2 Non-homogeneous Homogeneous 98.4 92.9 Cystic areas Hyperechoic deposits Reticulation Sand pattern 78.6 82.4 100 78.2 Absent Present 94.1 90.3 Absent Present 94.1 90.3 Absent Present 94.1 97.1 Absent Present 92.1 90.9 Present Partial Present Complete 91.3 85.6 1 2 3 4 90.3 89.7 86.5 93.5 Hilar Transcapsular Combined 91.2 79.1 71.5