Interobserver Variability in Hysterosalpingography Interpretation: Radiologists vs Gynecologists.

Area of Science:

• Reproductive medicine
• Radiology
• Gynecology

Background:

• Hysterosalpingography (HSG) is crucial for evaluating female infertility.
• Variability in HSG interpretation can impact patient management and outcomes.

Purpose of the Study:

• To assess interobserver agreement in HSG interpretation among radiologists and gynecologists.
• To identify areas of diagnostic consistency and discrepancy in HSG readings.

Main Methods:

• Prospective, multicenter study involving 12 specialists (6 radiologists, 6 gynecologists).
• Independent review of 100 HSG examinations across 10 diagnostic categories and image quality.
• Statistical analysis using Fleiss' kappa (κ) to measure interobserver agreement.

Main Results:

• Interobserver agreement varied from poor to moderate across most categories.
• Highest agreement observed for tubal occlusion (κ ≈ 0.5), uterine anomalies, and hydrosalpinx.
• Poor agreement (< 0.1) noted for subjective parameters like image quality and additional findings.

Conclusions:

• Significant interobserver variability in HSG interpretation exists, particularly between specialties.
• Structured findings show higher agreement than subjective assessments.
• Standardized reporting, interdisciplinary collaboration, and AI-assisted interpretation are recommended to improve diagnostic consistency.