Temel Tirkes1, Zarine K Shah2, Naoki Takahashi3, Joseph R Grajo4, Stephanie T Chang5, Ashley M Wachsman6, Kareem Mawad7, Carlos A Farinas8, Liang Li9, Savitri N Appana9, Darwin L Conwell10, Dhiraj Yadav11, Anil K Dasyam12. 1. Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd. Suite 0663, Indianapolis, IN, 46202, USA. atirkes@iu.edu. 2. Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA. 3. Department of Radiology, Mayo Clinic, Rochester, MN, USA. 4. University of Florida College of Medicine, Gainesville, FL, USA. 5. Department of Radiology and Division of Body MRI, Stanford University School of Medicine, Stanford, CA, USA. 6. Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 7. Department of Radiology, South San Francisco Medical Center, The Permanente Medical Group, South San Francisco, CA, USA. 8. Department of Radiology, Baylor College of Medicine, Houston, TX, USA. 9. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 10. Division of Gastroenterology, Department of Medicine, Ohio State University Wexner Medical Center, Hepatology & Nutrition, Columbus, OH, USA. 11. Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 12. Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Abstract
PURPOSE: Determine inter-observer variability among radiologists in assigning Cambridge Classification (CC) of chronic pancreatitis (CP) based on magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) and contrast-enhanced CT (CECT). METHODS: Among 422 eligible subjects enrolled into the PROCEED study between 6/2017 and 8/2018, 39 were selected randomly for this study (chronic abdominal pain (n = 8; CC of 0), suspected CP (n = 22; CC of 0, 1 or 2) or definite CP (n = 9; CC of 3 or 4). Each imaging was scored by the local radiologist (LRs) and three of five central radiologists (CRs) at other consortium sites. The CRs were blinded to clinical data and site information of the participants. We compared the CC score assigned by the LR with the consensus CC score assigned by the CRs. The weighted kappa statistic (K) was used to estimate the inter-observer agreement. RESULTS: For the majority of subjects (34/39), the group assignment by LR agreed with the consensus composite CT/MRCP score by the CRs (concordance ranging from 75 to 89% depending on cohort group). There was moderate agreement (63% and 67% agreed, respectively) between CRs and LRs in both the CT score (weighted Kappa [95% CI] = 0.56 [0.34, 0.78]; p-value = 0.57) and the MR score (weighted Kappa [95% CI] = 0.68 [0.49, 0.86]; p-value = 0.72). The composite CT/MR score showed moderate agreement (weighted Kappa [95% CI] = 0.62 [0.43, 0.81]; p-value = 0.80). CONCLUSION: There is a high degree of concordance among radiologists for assignment of CC using MRI and CT.
PURPOSE: Determine inter-observer variability among radiologists in assigning Cambridge Classification (CC) of chronic pancreatitis (CP) based on magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) and contrast-enhanced CT (CECT). METHODS: Among 422 eligible subjects enrolled into the PROCEED study between 6/2017 and 8/2018, 39 were selected randomly for this study (chronic abdominal pain (n = 8; CC of 0), suspected CP (n = 22; CC of 0, 1 or 2) or definite CP (n = 9; CC of 3 or 4). Each imaging was scored by the local radiologist (LRs) and three of five central radiologists (CRs) at other consortium sites. The CRs were blinded to clinical data and site information of the participants. We compared the CC score assigned by the LR with the consensus CC score assigned by the CRs. The weighted kappa statistic (K) was used to estimate the inter-observer agreement. RESULTS: For the majority of subjects (34/39), the group assignment by LR agreed with the consensus composite CT/MRCP score by the CRs (concordance ranging from 75 to 89% depending on cohort group). There was moderate agreement (63% and 67% agreed, respectively) between CRs and LRs in both the CT score (weighted Kappa [95% CI] = 0.56 [0.34, 0.78]; p-value = 0.57) and the MR score (weighted Kappa [95% CI] = 0.68 [0.49, 0.86]; p-value = 0.72). The composite CT/MR score showed moderate agreement (weighted Kappa [95% CI] = 0.62 [0.43, 0.81]; p-value = 0.80). CONCLUSION: There is a high degree of concordance among radiologists for assignment of CC using MRI and CT.
Entities:
Keywords:
Chronic pancreatitis; Computerized tomography; Inter-observer variability; Magnetic resonance cholangiopancreatography
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