S Jamali1, R Fahed1, J-C Gentric2, L Letourneau-Guillon1, H Raoult3, F Bing4, L Estrade5, T N Nguyen6, É Tollard7, J-C Ferre3, D Iancu8, O Naggara9, M Chagnon10, A Weill1, D Roy1, A J Fox11, D F Kallmes12, J Raymond13. 1. From the Department of Radiology (S.J., R.F., J.-C.G., L.L.-G., A.W., D.R., J.R.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada. 2. From the Department of Radiology (S.J., R.F., J.-C.G., L.L.-G., A.W., D.R., J.R.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada Groupe d'étude de la Thrombose en Bretagne Occidentale (J.-C.G.), Brest, France. 3. Service de radiologie et imagerie médicale (H.R., J.-C.F.), Centre Hospitalier Universitaire de Rennes, Rennes, France. 4. Service imagerie médicale et interventionnelle (F.B.), Centre Hospitalier Annecy Genevois, St-Julien en Genevois, France. 5. Service Imagerie, Médecine nucléaire et Explorations fonctionnelles (L.E.), Centre Hospitalier Régional Universitaire de Lille, Lille, France. 6. Departments of Neurology, Neurosurgery, and Radiology (T.N.N.), Boston Medical Center, Boston, Massachusetts. 7. Service d'Imagerie Médicale (E.T.), Centre Hospitalier Universitaire Hôpitaux de Rouen, Charles Nicolle, Rouen, France. 8. Service of Diagnostic Imaging (D.I.), The Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada;. 9. Service d'Imagerie Morphologique et Fonctionnelle (O.N.), Centre Hospitalier Sainte Anne, Paris, France. 10. Department of Mathematics and Statistics (M.C.), University of Montreal, Montreal, Quebec, Canada. 11. Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada. 12. Department of Neurointerventional Radiology (D.F.K.), Mayo Clinic, Rochester, Minnesota. 13. From the Department of Radiology (S.J., R.F., J.-C.G., L.L.-G., A.W., D.R., J.R.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada jean.raymond@umontreal.ca.
Abstract
BACKGROUND AND PURPOSE: Patients treated with coiling are often followed by MR angiography. Our objective was to assess the inter- and intraobserver agreement in diagnosing aneurysm remnants and recurrences by using multimodality imaging, including TOF MRA. MATERIALS AND METHODS: A portfolio composed of 120 selected images from 56 patients was sent to 15 neuroradiologists from 10 institutions. For each case, raters were asked to classify angiographic results (3 classes) of 2 studies (32 MRA-MRA and 24 DSA-MRA pairs) and to provide a final judgment regarding the presence of a recurrence (no, minor, major). Six raters were asked to independently review the portfolio twice. A second study, restricted to 4 raters having full access to all images, was designed to validate the results of the electronic survey. RESULTS: The proportion of cases judged to have a major recurrence varied between 16.1% and 71.4% (mean, 35.0% ± 12.7%). There was moderate agreement overall (κ = 0.474 ± 0.009), increasing to nearly substantial (κ = 0.581 ± 0.014) when the judgment was dichotomized (presence or absence of a major recurrence). Agreement on cases followed-up by MRA-MRA was similarly substantial (κ = 0.601 ± 0.018). The intrarater agreement varied between fair (κ = 0.257 ± 0.093) and substantial (κ= 0.699 ± 0.084), improving with a dichotomized judgment concerning MRA-MRA comparisons. Agreement was no better when raters had access to all images. CONCLUSIONS: There is an important variability in the assessment of angiographic outcomes of endovascular treatments. Agreement on the presence of a major recurrence when comparing 2 MRA studies or the MRA with the last catheter angiographic study can be substantial.
BACKGROUND AND PURPOSE:Patients treated with coiling are often followed by MR angiography. Our objective was to assess the inter- and intraobserver agreement in diagnosing aneurysm remnants and recurrences by using multimodality imaging, including TOF MRA. MATERIALS AND METHODS: A portfolio composed of 120 selected images from 56 patients was sent to 15 neuroradiologists from 10 institutions. For each case, raters were asked to classify angiographic results (3 classes) of 2 studies (32 MRA-MRA and 24 DSA-MRA pairs) and to provide a final judgment regarding the presence of a recurrence (no, minor, major). Six raters were asked to independently review the portfolio twice. A second study, restricted to 4 raters having full access to all images, was designed to validate the results of the electronic survey. RESULTS: The proportion of cases judged to have a major recurrence varied between 16.1% and 71.4% (mean, 35.0% ± 12.7%). There was moderate agreement overall (κ = 0.474 ± 0.009), increasing to nearly substantial (κ = 0.581 ± 0.014) when the judgment was dichotomized (presence or absence of a major recurrence). Agreement on cases followed-up by MRA-MRA was similarly substantial (κ = 0.601 ± 0.018). The intrarater agreement varied between fair (κ = 0.257 ± 0.093) and substantial (κ= 0.699 ± 0.084), improving with a dichotomized judgment concerning MRA-MRA comparisons. Agreement was no better when raters had access to all images. CONCLUSIONS: There is an important variability in the assessment of angiographic outcomes of endovascular treatments. Agreement on the presence of a major recurrence when comparing 2 MRA studies or the MRA with the last catheter angiographic study can be substantial.
Authors: Jimmy Ghostine; Naim Khoury; Francis Cloutier; Marc Kotowski; Jean-Christophe Gentric; André L Batista; Alain Weill; Daniel Roy; Tim E Darsaut; Jean Raymond Journal: Interv Neuroradiol Date: 2016-08-16 Impact factor: 1.610
Authors: Anass Benomar; Behzad Farzin; David Volders; Guylaine Gevry; Justine Zehr; Robert Fahed; William Boisseau; Jean-Christophe Gentric; Elsa Magro; Lorena Nico; Daniel Roy; Alain Weill; Charbel Mounayer; François Guilbert; Laurent Létourneau-Guillon; Gregory Jacquin; Chiraz Chaalala; Marc Kotowski; Thanh N Nguyen; David Kallmes; Phil White; Tim E Darsaut; Jean Raymond Journal: Neuroradiology Date: 2021-02-24 Impact factor: 2.804
Authors: A Benomar; B Farzin; G Gevry; W Boisseau; D Roy; A Weill; D Iancu; F Guilbert; L Létourneau-Guillon; G Jacquin; C Chaalala; M W Bojanowski; M Labidi; R Fahed; D Volders; T N Nguyen; J-C Gentric; E Magro; G Boulouis; G Forestier; J-F Hak; J S Ghostine; Z Kaderali; J J Shankar; M Kotowski; T E Darsaut; J Raymond Journal: AJNR Am J Neuroradiol Date: 2021-07-29 Impact factor: 4.966