Kerry Siminoski1, Brian Lentle, Mary Ann Matzinger, Nazih Shenouda, Leanne M Ward. 1. Department of Radiology and Diagnostic Imaging and Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, 6628-123 St., Edmonton, Canada, T6H 3T6, kerrygs@telusplanet.net.
Abstract
BACKGROUND: The Genant semiquantitative (GSQ) method has been a standard procedure for diagnosis of vertebral fractures in adults but has only recently been shown to be of clinical utility in children. Observer agreement using the GSQ method in this age group has not been described. OBJECTIVE: To evaluate observer agreement on vertebral readability and vertebral fracture diagnosis using the GSQ method in pediatric vertebral morphometry. MATERIALS AND METHODS: Spine radiographs of 186 children with acute lymphoblastic leukemia were evaluated independently by three radiologists using the same GSQ methodology as in adults. A subset of 100 radiographs was evaluated on two occasions. RESULTS: An average of 4.7% of vertebrae were unreadable for the three radiologists. Intraobserver Cohen's kappa (κ) on readability ranged from 0.434 to 0.648 at the vertebral level and from 0.416 to 0.611 at the patient level, while interobserver κ for readability had a range of 0.330 to 0.504 at the vertebral level and 0.295 to 0.467 at the patient level. Intraobserver κ for the presence of vertebral fracture had a range of 0.529 to 0.726 at the vertebral level and was 0.528 to 0.767 at the patient level. Interobserver κ for fracture at the vertebral level ranged from 0.455 to 0.548 and from 0.433 to 0.486 at the patient level. CONCLUSION: Most κ values for both intra- and interobserver agreement in applying the GSQ method to pediatric spine radiographs were in the moderate to substantial range, comparable to the performance of the technique in adult studies. The GSQ method should be considered for use in pediatric research and clinical practice.
BACKGROUND: The Genant semiquantitative (GSQ) method has been a standard procedure for diagnosis of vertebral fractures in adults but has only recently been shown to be of clinical utility in children. Observer agreement using the GSQ method in this age group has not been described. OBJECTIVE: To evaluate observer agreement on vertebral readability and vertebral fracture diagnosis using the GSQ method in pediatric vertebral morphometry. MATERIALS AND METHODS: Spine radiographs of 186 children with acute lymphoblastic leukemia were evaluated independently by three radiologists using the same GSQ methodology as in adults. A subset of 100 radiographs was evaluated on two occasions. RESULTS: An average of 4.7% of vertebrae were unreadable for the three radiologists. Intraobserver Cohen's kappa (κ) on readability ranged from 0.434 to 0.648 at the vertebral level and from 0.416 to 0.611 at the patient level, while interobserver κ for readability had a range of 0.330 to 0.504 at the vertebral level and 0.295 to 0.467 at the patient level. Intraobserver κ for the presence of vertebral fracture had a range of 0.529 to 0.726 at the vertebral level and was 0.528 to 0.767 at the patient level. Interobserver κ for fracture at the vertebral level ranged from 0.455 to 0.548 and from 0.433 to 0.486 at the patient level. CONCLUSION: Most κ values for both intra- and interobserver agreement in applying the GSQ method to pediatric spine radiographs were in the moderate to substantial range, comparable to the performance of the technique in adult studies. The GSQ method should be considered for use in pediatric research and clinical practice.
Authors: Nathalie Alos; Ronald M Grant; Timothy Ramsay; Jacqueline Halton; Elizabeth A Cummings; Paivi M Miettunen; Sharon Abish; Stephanie Atkinson; Ronald Barr; David A Cabral; Elizabeth Cairney; Robert Couch; David B Dix; Conrad V Fernandez; John Hay; Sara Israels; Caroline Laverdière; Brian Lentle; Victor Lewis; MaryAnn Matzinger; Celia Rodd; Nazih Shenouda; Robert Stein; David Stephure; Shayne Taback; Beverly Wilson; Kathryn Williams; Frank Rauch; Kerry Siminoski; Leanne M Ward Journal: J Clin Oncol Date: 2012-06-25 Impact factor: 44.544
Authors: P Szulc; F Munoz; E Sornay-Rendu; E Paris; E Souhami; J Zanchetta; A Bagur; M J van der Mooren; S Young; P D Delmas Journal: Bone Date: 2000-12 Impact factor: 4.398
Authors: David R Weber; Alison Boyce; Catherine Gordon; Wolfgang Högler; Heidi H Kecskemethy; Madhusmita Misra; Diana Swolin-Eide; Peter Tebben; Leanne M Ward; Halley Wasserman; Christopher Shuhart; Babette S Zemel Journal: J Clin Densitom Date: 2019-07-10 Impact factor: 2.617
Authors: Jacob L Jaremko; Kerry Siminoski; Gregory B Firth; Mary Ann Matzinger; Nazih Shenouda; Victor N Konji; Johannes Roth; Anne Marie Sbrocchi; Martin H Reed; Mary Kathleen O'Brien; Helen Nadel; Scott McKillop; Reinhard Kloiber; Josée Dubois; Craig Coblentz; Martin Charron; Leanne M Ward Journal: Pediatr Radiol Date: 2015-04-01
Authors: L M Ward; J Ma; F Rauch; E I Benchimol; J Hay; M B Leonard; M A Matzinger; N Shenouda; B Lentle; H Cosgrove; M Scharke; V N Konji; D R Mack Journal: Osteoporos Int Date: 2017-08-08 Impact factor: 4.507
Authors: E Adiotomre; L Summers; A Allison; S J Walters; M Digby; P Broadley; I Lang; G Morrison; N Bishop; P Arundel; A C Offiah Journal: Eur Radiol Date: 2016-09-21 Impact factor: 5.315