CT-based adaptation of the Vizzielli laparoscopic risk-adjusted score in advanced ovarian cancer: Agreement and inter-reader reproducibility
Related Experiment Video
Updated: Nov 3, 2026
Quantitation of Intra-peritoneal Ovarian Cancer Metastasis
Published on: July 18, 2016
E Versienti1, M Arcieri2, M De Martino3
1Institute of Radiology, Department of Medicine (DMED), University of Udine, Udine, Italy.
Purpose:
To evaluate agreement of proposed CT-based variants with the Vizzielli laparoscopic risk-adjusted score in suspected advanced ovarian cancer and assess inter-reader agreement of CT-derived components.
Methods:
This retrospective single-center study included consecutive adults evaluated between January 2021 and November 2025 for suspected advanced ovarian cancer who underwent contrast-enhanced abdominopelvic CT and staging laparoscopy. Proposed CT-based modifications were operationalized as six score variants combining CT-derived peritoneal tumor burden, CT-estimated ascites, cancer antigen 125 (CA-125), and either Eastern Cooperative Oncology Group performance status (ECOG-PS) or CT-derived body composition parameters. Agreement with the laparoscopic risk-adjusted score was assessed using the intraclass correlation coefficient (ICC), Spearman correlation coefficient, and weighted Cohen's kappa.
Results:
The final cohort included 80 patients. All CT-based variants showed agreement with the laparoscopic risk-adjusted score. For the variant combining CT-derived PCI, CT-estimated ascites, ECOG-PS, and CA-125, the consistency ICC was 0.76, Spearman's ρ was 0.806, and weighted Cohen's kappa was 0.76. This variant showed 70.0% agreement across the three risk categories and 83.8% agreement for high-risk versus non-high-risk classification, classifying 20 of 22 laparoscopic high-risk patients as high risk. The PCI-based skeletal muscle index (SMI) variant maintained substantial agreement: ICC, 0.73; Spearman correlation coefficient, 0.742; weighted Cohen's kappa, 0.74. Inter-reader agreement was high for CT-derived PCI, with an ICC of 0.91.
Conclusion:
Proposed CT-based variants showed agreement with the Vizzielli laparoscopic risk-adjusted score. The PCI-based ECOG-PS variant showed the highest agreement metrics, suggesting that structured CT assessment may help approximate laparoscopic risk categories before invasive evaluation.