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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(08): E1065-E1072
DOI: 10.1055/a-1779-5027
Original article

First interobserver agreement of optical coherence tomography in the bile duct: A multicenter collaborative study[*]

Amy Tyberg
 1   Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
,
Isaac Raijman
 2   Baylor St Lukes Medical Center, Houston, Texas, United States
,
Monica Gaidhane
 1   Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
,
Arvind J. Trindade
 3   Long Island Jewish Medical Center, New Hyde Park, New York, United States
,
Haroon Shahid
 1   Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
,
Avik Sarkar
 1   Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
,
Jason Samarasena
 4   University of California Irvine, Irvine, California, United States
,
Iman Andalib
 5   Mount Sinai South Nassau, Oceanside, New York, United States
,
David L. Diehl
 6   Geisinger Medical Center, Danville, Pennsylvania, United States
,
Douglas K. Pleskow
 7   Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
,
Kevin E. Woods
 8   Southeastern Regional Medical Center, Lumberton, North Carolina, United States
,
Stuart R. Gordon
 9   Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
,
Rahul Pannala
10   Mayo Clinic Phoenix, Phoenix, Arizona, United States
,
Prashant Kedia
11   Methodist Dallas Medical Center, Dallas, Texas, United States
,
Peter V. Draganov
12   University of Florida, Gainesville, Gainesville, Florida, United States
,
Paul R. Tarnasky
11   Methodist Dallas Medical Center, Dallas, Texas, United States
,
Divyesh V. Sejpal
13   North Shore University Hospital, Manhasset, New York, United States
,
Nikhil A. Kumta
14   Mount Sinai Hospital, New York, New York, United States
,
Gulshan Parasher
15   University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
,
Douglas G. Adler
16   University of Utah School of Medicine, Salt Lake City, Utah, United States
,
Kalpesh Patel
17   Baylor College of Medicine, Houston, Texas, United States
,
Dennis Yang
12   University of Florida, Gainesville, Gainesville, Florida, United States
,
Uzma Siddiqui
18   University of Chicago, Chicago, Illinois, United States
,
Michel Kahaleh
 1   Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
,
Viren Joshi
19   Ochsner Medical Center, New Orleans, Louisiana, United States
› Author Affiliations TRIAL REGISTRATION: NinePoint Medical NCT03951324. The study was a Interobserver study, and deemed exempt from Ethics board review by the WCG IRB at Rutgers Robert Wood Johnson Medical School
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Abstract

Background and study aims Optical coherence tomography (OCT) is a new technology available for evaluation of indeterminate biliary strictures. It allows under-the-surface visualization and preliminary studies have confirmed standardized characteristics associated with malignancy. The aim of this study is to evaluate the first interobserver agreement in identifying previously agreed upon OCT criteria and diagnosing of malignant versus benign disease.

Patients and methods Fourteen endoscopists were asked to review an atlas of reference clips and images of eight criteria derived from expert consensus A total of 35 de-identified video clips were then evaluated for presence of the eight criteria and for final diagnosis of malignant versus benign using the atlas as reference Intraclass correlation (ICC) analysis was done to evaluate interrater agreement.

Results Clips of 23 malignant lesions and 12 benign lesions were scored. Excellent interobserver agreement was seen with dilated hypo-reflective structures (0.85) and layering effacement (0.89); hyper-glandular mucosa (0.76), intact layering (0.81), and onion-skin layering (0.77); fair agreement was seen with scalloping (0.58), and thickened epithelium (0.4); poor agreement was seen with hyper-reflective surface (0.36). The diagnostic ICC for both neoplastic (0.8) and non-neoplastic (0.8) was excellent interobserver agreement. The overall diagnostic accuracy was 51 %, ranging from 43 % to 60 %.

Conclusions Biliary OCT is a promising new modality for evaluation of indeterminate biliary strictures. Interobserver agreement ranged from fair to almost perfect on eight previously identified criteria. Interobserver agreement for malignancy diagnosis was substantial (0.8). Further studies are needed to validate this data.

* Meeting presentations: This study’s abstract was presented as a scientific research presentation at DDW 2020.




Publication History

Received: 19 November 2021

Accepted after revision: 22 February 2022

Accepted Manuscript online:
22 March 2022

Article published online:
15 August 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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