BACKGROUND AND PURPOSE: Lesion volume measured on follow-up magnetic resonance imaging (MRI) is commonly used as an outcome parameter in clinical stroke trials. However, few studies have evaluated the optimal sequence choice and the interrater reliability of this outcome measure. The objective of this study was to quantify the geometric interrater agreement for lesion delineation of chronic infarcts on T2-weighted and fluid-attenuated inverse recovery (FLAIR) MRI. METHODS: In a retrospective study of 14 patients, lesions on 90-day follow-up FLAIR and T2 fast spin echo MRI were outlined by 9 independent, blinded, experienced neuroradiologists. Voxel-wise interrater agreement was measured as (1) the volume of the intersection of individual rater's lesion outlines relative to the mean lesion volume (overlap ratio) and (2) the Hausdorff distance between the lesion markings. RESULTS: Mean patient age was 64.4 years (range, 45 to 79). Lesion volumes on FLAIR were, on average, 2.5 mL greater than were T2 volumes (median; P<0.001). We found considerable differences between raters' lesion markings, but interrater agreement was consistently better on FLAIR than on T2 images, as measured by a greater overlap ratio (P<0.0001) and a smaller Hausdorff distance (P<0.0001) on FLAIR than on T2. CONCLUSIONS: FLAIR should be used to quantify follow-up infarct size to minimize interrater variability. Our study suggests that imaging analysis performed by 1 or a few trained readers may be preferred. Future studies should address objective and preferably automated criteria for final lesion delineation.
BACKGROUND AND PURPOSE: Lesion volume measured on follow-up magnetic resonance imaging (MRI) is commonly used as an outcome parameter in clinical stroke trials. However, few studies have evaluated the optimal sequence choice and the interrater reliability of this outcome measure. The objective of this study was to quantify the geometric interrater agreement for lesion delineation of chronic infarcts on T2-weighted and fluid-attenuated inverse recovery (FLAIR) MRI. METHODS: In a retrospective study of 14 patients, lesions on 90-day follow-up FLAIR and T2 fast spin echo MRI were outlined by 9 independent, blinded, experienced neuroradiologists. Voxel-wise interrater agreement was measured as (1) the volume of the intersection of individual rater's lesion outlines relative to the mean lesion volume (overlap ratio) and (2) the Hausdorff distance between the lesion markings. RESULTS: Mean patient age was 64.4 years (range, 45 to 79). Lesion volumes on FLAIR were, on average, 2.5 mL greater than were T2 volumes (median; P<0.001). We found considerable differences between raters' lesion markings, but interrater agreement was consistently better on FLAIR than on T2 images, as measured by a greater overlap ratio (P<0.0001) and a smaller Hausdorff distance (P<0.0001) on FLAIR than on T2. CONCLUSIONS: FLAIR should be used to quantify follow-up infarct size to minimize interrater variability. Our study suggests that imaging analysis performed by 1 or a few trained readers may be preferred. Future studies should address objective and preferably automated criteria for final lesion delineation.
Authors: Robert I Liem; Jingxia Liu; Mae O Gordon; Bruce A Vendt; Robert C McKinstry; Michael A Kraut; John J Strouse; William S Ball; Michael R DeBaun Journal: J Child Neurol Date: 2013-12-05 Impact factor: 1.987
Authors: G W J Harston; N Rane; G Shaya; S Thandeswaran; M Cellerini; F Sheerin; J Kennedy Journal: AJNR Am J Neuroradiol Date: 2015-01-29 Impact factor: 3.825
Authors: Bjoern H Menze; Heinz Handels; Mauricio Reyes; Oskar Maier; Janina von der Gablentz; Levin Ḧani; Mattias P Heinrich; Matthias Liebrand; Stefan Winzeck; Abdul Basit; Paul Bentley; Liang Chen; Daan Christiaens; Francis Dutil; Karl Egger; Chaolu Feng; Ben Glocker; Michael Götz; Tom Haeck; Hanna-Leena Halme; Mohammad Havaei; Khan M Iftekharuddin; Pierre-Marc Jodoin; Konstantinos Kamnitsas; Elias Kellner; Antti Korvenoja; Hugo Larochelle; Christian Ledig; Jia-Hong Lee; Frederik Maes; Qaiser Mahmood; Klaus H Maier-Hein; Richard McKinley; John Muschelli; Chris Pal; Linmin Pei; Janaki Raman Rangarajan; Syed M S Reza; David Robben; Daniel Rueckert; Eero Salli; Paul Suetens; Ching-Wei Wang; Matthias Wilms; Jan S Kirschke; Ulrike M Kr Amer; Thomas F Münte; Peter Schramm; Roland Wiest Journal: Med Image Anal Date: 2016-07-21 Impact factor: 8.545
Authors: Selma Lugtmeijer; Linda Geerligs; Frank Erik de Leeuw; Edward H F de Haan; Roy P C Kessels Journal: Brain Struct Funct Date: 2021-04-29 Impact factor: 3.270