M R S Siddiqui1, K L Gormly2, J Bhoday1, S Balyansikova3, N J Battersby3, M Chand4, S Rao3, P Tekkis5, A M Abulafi6, G Brown7. 1. Department of Colorectal Surgery, Croydon University Hospital, Croydon CR7 7YE, UK; Department of Radiology, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK; Imperial College London, London, UK. 2. Dr Jones and Partners, Adelaide, South Australia, Australia. 3. Department of Radiology, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK. 4. Department of Surgery, University College London, London, UK. 5. Department of Surgery, Royal Marsden Hospital, Fulham Rd, London SW3 6JJ, UK; Imperial College London, London, UK. 6. Department of Colorectal Surgery, Croydon University Hospital, Croydon CR7 7YE, UK. 7. Department of Radiology, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK; Imperial College London, London, UK. Electronic address: gina.brown@rmh.nhs.uk.
Abstract
AIM: To investigate whether the magnetic resonance imaging (MRI) tumour regression grading (mrTRG) scale can be taught effectively resulting in a clinically reasonable interobserver agreement (>0.4; moderate to near perfect agreement). MATERIALS AND METHODS: This study examines the interobserver agreement of mrTRG, between 35 radiologists and a central reviewer. Two workshops were organised for radiologists to assess regression of rectal cancers on MRI staging scans. A range of mrTRGs on 12 patient scans were used for assessment. RESULTS: Kappa agreement ranged from 0.14-0.82 with a median value of 0.57 (95% CI: 0.37-0.77) indicating good overall agreement. Eight (26%) radiologists had very good/near perfect agreement (κ>0.8). Six (19%) radiologists had good agreement (0.8≥κ>0.6) and a further 12 (39%) had moderate agreement (0.6≥κ>0.4). Five (16%) radiologists had a fair agreement (0.4≥κ>0.2) and two had poor agreement (0.2>κ). There was a tendency towards good agreement (skewness: 0.92). In 65.9% and 90% of cases the radiologists were able to correctly highlight good and poor responders, respectively. CONCLUSIONS: The assessment of the response of rectal cancers to chemoradiation therapy may be performed effectively using mrTRG. Radiologists can be taught the mrTRG scale. Even with minimal training, good agreement with the central reviewer along with effective differentiation between good and intermediate/poor responders can be achieved. Focus should be on facilitating the identification of good responders. It is predicted that with more intensive interactive case-based learning a κ>0.8 is likely to be achieved. Testing and retesting is recommended.
AIM: To investigate whether the magnetic resonance imaging (MRI) tumour regression grading (mrTRG) scale can be taught effectively resulting in a clinically reasonable interobserver agreement (>0.4; moderate to near perfect agreement). MATERIALS AND METHODS: This study examines the interobserver agreement of mrTRG, between 35 radiologists and a central reviewer. Two workshops were organised for radiologists to assess regression of rectal cancers on MRI staging scans. A range of mrTRGs on 12 patient scans were used for assessment. RESULTS: Kappa agreement ranged from 0.14-0.82 with a median value of 0.57 (95% CI: 0.37-0.77) indicating good overall agreement. Eight (26%) radiologists had very good/near perfect agreement (κ>0.8). Six (19%) radiologists had good agreement (0.8≥κ>0.6) and a further 12 (39%) had moderate agreement (0.6≥κ>0.4). Five (16%) radiologists had a fair agreement (0.4≥κ>0.2) and two had poor agreement (0.2>κ). There was a tendency towards good agreement (skewness: 0.92). In 65.9% and 90% of cases the radiologists were able to correctly highlight good and poor responders, respectively. CONCLUSIONS: The assessment of the response of rectal cancers to chemoradiation therapy may be performed effectively using mrTRG. Radiologists can be taught the mrTRG scale. Even with minimal training, good agreement with the central reviewer along with effective differentiation between good and intermediate/poor responders can be achieved. Focus should be on facilitating the identification of good responders. It is predicted that with more intensive interactive case-based learning a κ>0.8 is likely to be achieved. Testing and retesting is recommended.
Authors: Natally Horvat; Harini Veeraraghavan; Caio S R Nahas; David D B Bates; Felipe R Ferreira; Junting Zheng; Marinela Capanu; James L Fuqua; Maria Clara Fernandes; Ramon E Sosa; Vetri Sudar Jayaprakasam; Giovanni G Cerri; Sergio C Nahas; Iva Petkovska Journal: Abdom Radiol (NY) Date: 2022-06-16
Authors: Joao Miranda; Gary Xia Vern Tan; Maria Clara Fernandes; Onur Yildirim; John A Sims; Jose de Arimateia Batista Araujo-Filho; Felipe Augusto de M Machado; Antonildes N Assuncao-Jr; Cesar Higa Nomura; Natally Horvat Journal: Clin Imaging Date: 2021-11-16 Impact factor: 2.420