Reproducibility of the International Endometrial Analysis Group color score for assigning the amount of flow within the endometrium using stored 3-dimensional volumes

Objectives - To estimate intraobserver and interobserver reproducibility for assigning an International Endometrial Tumor Analysis (IETA) group color score for endometrial vascularization on color Doppler imaging. Methods - Sixty-eight endometrial 3-dimensional volumes from endometrial color Doppler assessments of women with different endometrial disorders were evaluated by 8 different examiners (4 skilled examiners and 4 obstetric and gynecologic trainees). One skilled examiner who did not participate in the assessments selected the 68 volumes from a database to select a balanced number of each IETA score. Each examiner evaluated the 68 endometrial volumes to assign the IETA color score (1, absence of vascularization; 2, low vascularization; 3, moderate vascularization; or 4, abundant vascularization) using tomographic ultrasound imaging. The analysis was repeated 4 weeks later, and interobserver and intraobserver reproducibility was analyzed by calculating the weighted j index. The second of the measurements made by each observer was used to estimate interobserver reproducibility. Results - The intraobserver reproducibility was very good for all examiners, with a weighted j index ranging from 0.84 to 0.91. The interobserver reproducibility was good or very good for all estimated comparisons, with a weighted j index ranging from 0.77 to 0.96, regardless of experience level. Conclusions - The reproducibility of assigning the IETA color score for assessing endometrial vascularization using 3-dimensional volumes is good or very good regardless of the experience of the examiner.