PURPOSE: To investigate the impact of interinstitutional variance (=interobserver variance between institutions) for volumetric and flow cardiac MR (CMR) data and if training on image reading could improve bias. MATERIALS AND METHODS: In a three-center study, a total of 32 adults with repaired Tetralogy of Fallot and 23 controls underwent CMR using standardized protocols for ventricular volumes/mass (by transverse and short-axis cine-MRI) and pulmonary/aortic blood flow by velocity-encoded MRI (VEC-MRI). Data were analyzed blinded and independently in each institution by experienced readers. Interinstitutional variance was determined before/after training on consented guidelines for image analysis. RESULTS: In patients, initial interinstitutional variability of right ventricular parameters was substantial but decreased by training. On transverse planes, variation coefficient for end-diastolic/systolic volumes and ejection fraction decreased from 22%, 19%, and 19% to 7%, 10%, and 8%, respectively (P < 0.025). Left-ventricular variation coefficients improved for end-diastolic and stroke volumes from 8% and 15% to 4% and 6%, respectively (P < 0.007). For short-axis volumetry training resulted in narrowed limits of confidence. Variability did not significantly change in the controls. There was no significant difference between transverse/short-axis MRI. Interinstitutional variance for VEC-MRI in patients/controls was low (<4%). CONCLUSION: Interinstitutional variance is an important source of variability in volumetric but not in flow CMR. Such variance can be reduced effectively by consented training.
PURPOSE: To investigate the impact of interinstitutional variance (=interobserver variance between institutions) for volumetric and flow cardiac MR (CMR) data and if training on image reading could improve bias. MATERIALS AND METHODS: In a three-center study, a total of 32 adults with repaired Tetralogy of Fallot and 23 controls underwent CMR using standardized protocols for ventricular volumes/mass (by transverse and short-axis cine-MRI) and pulmonary/aortic blood flow by velocity-encoded MRI (VEC-MRI). Data were analyzed blinded and independently in each institution by experienced readers. Interinstitutional variance was determined before/after training on consented guidelines for image analysis. RESULTS: In patients, initial interinstitutional variability of right ventricular parameters was substantial but decreased by training. On transverse planes, variation coefficient for end-diastolic/systolic volumes and ejection fraction decreased from 22%, 19%, and 19% to 7%, 10%, and 8%, respectively (P < 0.025). Left-ventricular variation coefficients improved for end-diastolic and stroke volumes from 8% and 15% to 4% and 6%, respectively (P < 0.007). For short-axis volumetry training resulted in narrowed limits of confidence. Variability did not significantly change in the controls. There was no significant difference between transverse/short-axis MRI. Interinstitutional variance for VEC-MRI in patients/controls was low (<4%). CONCLUSION: Interinstitutional variance is an important source of variability in volumetric but not in flow CMR. Such variance can be reduced effectively by consented training.
Authors: Gert Klug; Sebastian Johannes Reinstadler; Hans-Josef Feistritzer; Christian Kremser; Johannes P Schwaiger; Martin Reindl; Johannes Mair; Silvana Müller; Agnes Mayr; Wolfgang-Michael Franz; Bernhard Metzler Journal: Eur Radiol Date: 2015-09-18 Impact factor: 5.315
Authors: Hendrik G Freling; Kees van Wijk; Karolien Jaspers; Petronella G Pieper; Karin M Vermeulen; Jeroen M van Swieten; Tineke P Willems Journal: Int J Cardiovasc Imaging Date: 2012-09-04 Impact factor: 2.357
Authors: Mieke M P Driessen; Vivan J M Baggen; Hendrik G Freling; Petronella G Pieper; Arie P van Dijk; Pieter A Doevendans; Repke J Snijder; Marco C Post; Folkert J Meijboom; Gertjan T Sieswerda; Tim Leiner; Tineke P Willems Journal: Int J Cardiovasc Imaging Date: 2014-01-20 Impact factor: 2.357
Authors: M Grothoff; J Hoffmann; L Lehmkuhl; H Abdul-Khaliq; S Nitzsche; A Mahler; I Dähnert; F Berger; M Gutberlet Journal: Clin Res Cardiol Date: 2010-11-19 Impact factor: 5.460
Authors: Eugénie Riesenkampff; Lena Mengelkamp; Matthias Mueller; Siegfried Kropf; Hashim Abdul-Khaliq; Samir Sarikouch; Philipp Beerbaum; Roland Hetzer; Paul Steendijk; Felix Berger; Titus Kuehne Journal: Am J Physiol Heart Circ Physiol Date: 2010-05-21 Impact factor: 4.733