Nicolai Maldaner1, Martin N Stienen2, Philippe Bijlenga3, Davide Croci4, Daniel W Zumofen5, Donato Dalonzo6, Serge Marbacher6, Rodolfo Maduri7, Roy Thomas Daniel7, Carlo Serra8, Giuseppe Esposito8, Marian Christoph Neidert8, Oliver Bozinov8, Luca Regli8, Jan-Karl Burkhardt8. 1. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland. Electronic address: nicolai.maldaner@usz.ch. 2. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Department of Neurosurgery, University Clinic Geneva, Geneva, Switzerland. 3. Department of Neurosurgery, University Clinic Geneva, Geneva, Switzerland. 4. Department of Neurosurgery, Basel University Hospital, Basel, Switzerland. 5. Department of Neurosurgery, Basel University Hospital, Basel, Switzerland; Section for Diagnostic and Interventional Neuroradiology, Department of Radiology, Basel University Hospital, Basel, Switzerland. 6. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland. 7. Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 8. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
Abstract
OBJECTIVE: To determine interrater agreement in the initial radiologic characterization of ruptured intracranial aneurysms based on computed tomography angiography (CTA) with special emphasis on the rater's level of experience. METHODS: One junior and one senior rater of 5 high-volume neurovascular tertiary centers evaluated anonymized CTA images of 30 consecutive patients with aneurysmal subarachnoid hemorrhage. Each rater described location, side, size, and morphology in a standardized manner. Interrater variability was analyzed using intraclass correlation and Fleiss' kappa analysis. RESULTS: There was a high level of agreement for location (κ = 0.76, 95% confidence interval [CI] 0.74-0.79), side (κ = 0.95, CI 0.91-0.99), maximum diameter (intraclass correlation coefficient [ICC] 0.81, CI 0.70-0.90), and dome (ICC 0.78, CI 0.66-0.88) of intracranial aneurysms. In contrast, a lower level of agreement was observed for aneurysms' neck diameter (ICC 0.39, CI 0.28-0.58), the presence of multiple aneurysms (κ = 0.35, CI 0.30-0.40), and aneurysm morphology (blister κ = 0.11, CI -0.05 to 0.07; fusiform κ = 0.54, CI 0.48-0.60; multilobular, κ = 0.39 CI 0.33-0.45). The interrater agreement in the senior rater group was greater than in the junior rater group. CONCLUSIONS: Interrater agreement confirms the benefit of CTA as initial diagnostic imaging in ruptured intracranial aneurysms but not for aneurysm morphology and presence of multiple aneurysms. A trend towards greater interrater agreement between more experienced raters was noticed.
OBJECTIVE: To determine interrater agreement in the initial radiologic characterization of ruptured intracranial aneurysms based on computed tomography angiography (CTA) with special emphasis on the rater's level of experience. METHODS: One junior and one senior rater of 5 high-volume neurovascular tertiary centers evaluated anonymized CTA images of 30 consecutive patients with aneurysmal subarachnoid hemorrhage. Each rater described location, side, size, and morphology in a standardized manner. Interrater variability was analyzed using intraclass correlation and Fleiss' kappa analysis. RESULTS: There was a high level of agreement for location (κ = 0.76, 95% confidence interval [CI] 0.74-0.79), side (κ = 0.95, CI 0.91-0.99), maximum diameter (intraclass correlation coefficient [ICC] 0.81, CI 0.70-0.90), and dome (ICC 0.78, CI 0.66-0.88) of intracranial aneurysms. In contrast, a lower level of agreement was observed for aneurysms' neck diameter (ICC 0.39, CI 0.28-0.58), the presence of multiple aneurysms (κ = 0.35, CI 0.30-0.40), and aneurysm morphology (blister κ = 0.11, CI -0.05 to 0.07; fusiform κ = 0.54, CI 0.48-0.60; multilobular, κ = 0.39 CI 0.33-0.45). The interrater agreement in the senior rater group was greater than in the junior rater group. CONCLUSIONS: Interrater agreement confirms the benefit of CTA as initial diagnostic imaging in ruptured intracranial aneurysms but not for aneurysm morphology and presence of multiple aneurysms. A trend towards greater interrater agreement between more experienced raters was noticed.
Authors: Z Shi; B Hu; U J Schoepf; R H Savage; D M Dargis; C W Pan; X L Li; Q Q Ni; G M Lu; L J Zhang Journal: AJNR Am J Neuroradiol Date: 2020-03-12 Impact factor: 3.825
Authors: Allison Park; Chris Chute; Pranav Rajpurkar; Joe Lou; Robyn L Ball; Katie Shpanskaya; Rashad Jabarkheel; Lily H Kim; Emily McKenna; Joe Tseng; Jason Ni; Fidaa Wishah; Fred Wittber; David S Hong; Thomas J Wilson; Safwan Halabi; Sanjay Basu; Bhavik N Patel; Matthew P Lungren; Andrew Y Ng; Kristen W Yeom Journal: JAMA Netw Open Date: 2019-06-05
Authors: Pablo M Munarriz; Eduardo Bárcena; Jose F Alén; Ana M Castaño-Leon; Igor Paredes; Luis Miguel Moreno-Gómez; Daniel García-Pérez; Luis Jiménez-Roldán; Pedro A Gómez; Alfonso Lagares Journal: Interv Neuroradiol Date: 2020-09-30 Impact factor: 1.610
Authors: Lenhard Pennig; Ulrike Cornelia Isabel Hoyer; Alexandra Krauskopf; Rahil Shahzad; Stephanie T Jünger; Frank Thiele; Kai Roman Laukamp; Jan-Peter Grunz; Michael Perkuhn; Marc Schlamann; Christoph Kabbasch; Jan Borggrefe; Lukas Goertz Journal: Neuroradiology Date: 2021-04-10 Impact factor: 2.804