TRANSRECTAL ULTRASONOGRAPHY IN PROSTATE-CANCER - INTEREXAMINER VARIABILITY OF INTERPRETATION

Objective: To compare the variability of transrectal ultrasonographic (TRUS) interpretation for the decision of performing biopsies and the lesions to biopsy. Methods: We extracted at random from our videotape database 16 records of patients who had undergone biopsies, added 2 no rmal glands and duplicated 2 of these 18 records. Based on the records , 5 well-trained physicians had to describe the images on the tape, an d to decide whether or not to biopsy the prostate. a kappa test was co mputed between each couple of readers, and for the whole group. The ka ppa test denotes the agreement between examiners. A value of kappa < 0 .20 is considered poor to slight agreement, 0.2-0.40 is considered fai r agreement. Results: The agreement between the 5 readers was poor for the biopsy decision (kappa < 0.2) and the difficulty to read the reco rds (kappa = 0.05). The results with the global kappa were similar wit h a highest value <0.3. Most of the abnormalities were described in th e peripheral zone. The global kappa for the seminal vesicles interpret ation is poor, but better for the capsular penetration. Conclusion: TR US has a poor informative value between different practitioners. This poor agreement between different practitioners must lead to more objec tive ultrasonographic methods.