Marjolein M N Leeuwenburgh1, Bart M Wiarda2, Sebastiaan Jensch3, H Wouter van Es4, Hein B A C Stockmann5, Jan Willem C Gratama6, Lodewijk P J Cobben7, Patrick M M Bossuyt8, Marja A Boermeester9, Jaap Stoker10. 1. Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands; Department of Radiology, Academic Medical Center, University of Amsterdam, The Netherlands. Electronic address: m.m.leeuwenburgh@amc.uva.nl. 2. Department of Radiology, Alkmaar Medical Center, Alkmaar, The Netherlands. 3. Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands. 4. Department of Radiology, Sint Antonius Hospital, Nieuwegein, The Netherlands. 5. Department of Surgery, Kennemer Gasthuis, Haarlem, The Netherlands. 6. Department of Radiology, Gelre Hospitals, Apeldoorn, The Netherlands. 7. Department of Radiology, Haaglanden Medical Center, Leidschendam, The Netherlands. 8. Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam, The Netherlands. 9. Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands. 10. Department of Radiology, Academic Medical Center, University of Amsterdam, The Netherlands.
Abstract
OBJECTIVE: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. METHODS: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. RESULTS: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p=0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p=0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p<0.001) and specificity 0.71 versus 0.82 (p=0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). CONCLUSION: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.
OBJECTIVE: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. METHODS: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. RESULTS: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p=0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p=0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p<0.001) and specificity 0.71 versus 0.82 (p=0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). CONCLUSION: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.
Authors: Sorapop Kiatpongsan; Lesley Meng; Jonathan D Eisenberg; Maurice Herring; Laura L Avery; Chung Yin Kong; Pari V Pandharipande Journal: Radiology Date: 2014-07-01 Impact factor: 11.105
Authors: Juliane Liese; Thomas M Halbinger; Frank Ulrich; Wolf O Bechstein; Christoph W Strey Journal: Langenbecks Arch Surg Date: 2014-03-16 Impact factor: 3.445
Authors: Rebecca L Bracken; John B Harringa; B Keegan Markhardt; Newrhee Kim; John K Park; Douglas R Kitchin; Jessica B Robbins; Timothy J Ziemlewicz; Jen Birstler; Michael J Ryan; Ly Hoang; Perry J Pickhardt; Scott B Reeder; Michael D Repplinger Journal: Eur Radiol Date: 2021-07-16 Impact factor: 5.315
Authors: Imke H Bartelink; Ella F Jones; Sheerin K Shahidi-Latham; Pei Rong Evelyn Lee; Yanan Zheng; Paolo Vicini; Laura van 't Veer; Denise Wolf; Andrei Iagaru; Deanna L Kroetz; Brendan Prideaux; Cornelius Cilliers; Greg M Thurber; Zena Wimana; Geraldine Gebhart Journal: Clin Pharmacol Ther Date: 2018-10-06 Impact factor: 6.875