Is Grannum grading of the placenta reproducible?

Mary Moran; John Ryan; Patrick C. Brennan; Mary Higgins; Fionnuala M. McAuliffe

doi:10.1117/12.810993

12 March 2009 Is Grannum grading of the placenta reproducible?

Mary Moran, John Ryan, Patrick C. Brennan, Mary Higgins, Fionnuala M. McAuliffe

Author Affiliations +

Proceedings Volume 7263, Medical Imaging 2009: Image Perception, Observer Performance, and Technology Assessment; 72631W (2009) https://doi.org/10.1117/12.810993
Event: SPIE Medical Imaging, 2009, Lake Buena Vista (Orlando Area), Florida, United States

Abstract

Current ultrasound assessment of placental calcification relies on Grannum grading. The aim of this study was to assess if this method is reproducible by measuring inter- and intra-observer variation in grading placental images, under strictly controlled viewing conditions. Thirty placental images were acquired and digitally saved. Five experienced sonographers independently graded the images on two separate occasions. In order to eliminate any technological factors which could affect data reliability and consistency all observers reviewed images at the same time. To optimise viewing conditions ambient lighting was maintained between 25-40 lux, with monitors calibrated to the GSDF standard to ensure consistent brightness and contrast. Kappa (κ) analysis of the grades assigned was used to measure inter- and intra-observer reliability. Intra-observer agreement had a moderate mean κ-value of 0.55, with individual comparisons ranging from 0.30 to 0.86. Two images saved from the same patient, during the same scan, were each graded as I, II and III by the same observer. A mean κ-value of 0.30 (range from 0.13 to 0.55) indicated fair inter-observer agreement over the two occasions and only one image was graded consistently the same by all five observers. The study findings confirmed the lack of reproducibility associated with Grannum grading of the placenta despite optimal viewing conditions and highlight the need for new methods of assessing placental health in order to improve neonatal outcomes. Alternative methods for quantifying placental calcification such as a software based technique and 3D ultrasound assessment need to be explored.

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Mary Moran, John Ryan, Patrick C. Brennan, Mary Higgins, and Fionnuala M. McAuliffe "Is Grannum grading of the placenta reproducible?", Proc. SPIE 7263, Medical Imaging 2009: Image Perception, Observer Performance, and Technology Assessment, 72631W (12 March 2009); https://doi.org/10.1117/12.810993

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