Interobserver Reliability of the Antenatal Consensus Classification System for Urinary Tract Dilatation

Area of Science:

• Medical Imaging
• Fetal Medicine
• Urology

Background:

• The urinary tract dilatation (UTD) classification system was developed for improved objectivity and reproducibility in diagnosing urinary tract issues.
• Previous systems for assessing urinary tract dilatation lacked consistent reliability among healthcare providers.

Purpose of the Study:

• To evaluate the interobserver reliability of the UTD classification system's components and overall scores.
• To compare the reliability of the UTD system with the Society for Fetal Urology (SFU) scoring system in a prenatal ultrasound setting.

Main Methods:

• Retrospective review of antenatal ultrasound images from 300 fetuses with urinary tract dilatation.
• Independent assessment of UTD and SFU scores by 5 experienced sonologists (1 maternal-fetal medicine specialist, 4 radiologists).
• Interobserver agreement was quantified using the Fleiss κ statistic.

Main Results:

• Substantial overall interobserver agreement was found for the antenatal UTD risk score (κ = 0.657).
• The UTD system exhibited better agreement among readers compared to the SFU system (κ = 0.368).
• Lowest agreement was observed for parenchymal appearance assessment within the UTD system (κ = 0.225).

Conclusions:

• The antenatal UTD grading system demonstrates substantial interobserver reliability.
• The UTD classification system offers improved diagnostic consistency in prenatal ultrasound evaluations compared to the SFU system.