Mary Moran - Academia.edu (original) (raw)
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Universidade Federal de Santa Catarina - UFSC (Federal University of Santa Catarina)
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Papers by Mary Moran
Ultrasound assessment of placental calcification: Observer variation
Novel New Software Tool
Objective Placental calcification is associated with an increased risk of perinatal morbidity and... more Objective Placental calcification is associated with an increased risk of perinatal morbidity and mortality. The subjectivity of current ultrasound methods of assessment of placental calcification indicate that a more objective method is required. The aim of this study was to correlate the percentage of calcification defined by the clinician using a new software tool for calculating the extent of placental calcification, with traditional ultrasound methods and correlation with pregnancy outcome. Methods 90 placental images were individually assessed. An upper threshold was defined based on high intensity to quantify calcification within the placenta. Output metrics were then produced including the overall percentage of calcification in reference to the total number of pixels within the region of interest. The results were correlated with traditional ultrasound methods of assessment of placental calcification and with pregnancy outcome. Results The results demonstrate a significant c...
The 47th Annual Scientific Meeting of the British Medical Ultrasound Society: Ultrasound 2015, Ci... more The 47th Annual Scientific Meeting of the British Medical Ultrasound Society: Ultrasound 2015, City Hall, Cardiff, Wales, UK, 9 - 11 December 2015
SPIE Proceedings, 2009
Current ultrasound assessment of placental calcification relies on Grannum grading. The aim of th... more 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 interand 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.
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2014
Placenta, 2014
Some rights reserved. For more information, please see the item record link above.
Journal of Obstetrics and Gynaecology, 2011
Abnormal placental calcification is associated with poor pregnancy outcome. The aim of this study... more Abnormal placental calcification is associated with poor pregnancy outcome. The aim of this study was to measure inter-and intra-observer variability in assigning placental grades. Five experienced sonographers independently graded ninety images on two occasions. All technological factors which could affect data reliability and consistency were removed. Substantial variations between individuals' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair inter-observer agreement over the two occasions and only nine of the ninety images were graded the same by all five observers. Intra-observer agreement was moderate, with the mean κ-value 0.52. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even amongst expert observers. The need for new methods to assess placental health to improve neonatal outcomes is required and work is ongoing to develop a software based method using 2D and 3D image datasets.
Journal of Clinical Ultrasound, 2011
Some rights reserved. For more information, please see the item record link above.
Ultrasound assessment of placental calcification: Observer variation
Novel New Software Tool
Objective Placental calcification is associated with an increased risk of perinatal morbidity and... more Objective Placental calcification is associated with an increased risk of perinatal morbidity and mortality. The subjectivity of current ultrasound methods of assessment of placental calcification indicate that a more objective method is required. The aim of this study was to correlate the percentage of calcification defined by the clinician using a new software tool for calculating the extent of placental calcification, with traditional ultrasound methods and correlation with pregnancy outcome. Methods 90 placental images were individually assessed. An upper threshold was defined based on high intensity to quantify calcification within the placenta. Output metrics were then produced including the overall percentage of calcification in reference to the total number of pixels within the region of interest. The results were correlated with traditional ultrasound methods of assessment of placental calcification and with pregnancy outcome. Results The results demonstrate a significant c...
The 47th Annual Scientific Meeting of the British Medical Ultrasound Society: Ultrasound 2015, Ci... more The 47th Annual Scientific Meeting of the British Medical Ultrasound Society: Ultrasound 2015, City Hall, Cardiff, Wales, UK, 9 - 11 December 2015
SPIE Proceedings, 2009
Current ultrasound assessment of placental calcification relies on Grannum grading. The aim of th... more 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 interand 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.
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2014
Placenta, 2014
Some rights reserved. For more information, please see the item record link above.
Journal of Obstetrics and Gynaecology, 2011
Abnormal placental calcification is associated with poor pregnancy outcome. The aim of this study... more Abnormal placental calcification is associated with poor pregnancy outcome. The aim of this study was to measure inter-and intra-observer variability in assigning placental grades. Five experienced sonographers independently graded ninety images on two occasions. All technological factors which could affect data reliability and consistency were removed. Substantial variations between individuals' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair inter-observer agreement over the two occasions and only nine of the ninety images were graded the same by all five observers. Intra-observer agreement was moderate, with the mean κ-value 0.52. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even amongst expert observers. The need for new methods to assess placental health to improve neonatal outcomes is required and work is ongoing to develop a software based method using 2D and 3D image datasets.
Journal of Clinical Ultrasound, 2011
Some rights reserved. For more information, please see the item record link above.