Bari Dane1, Kun Qian2, Simon Gauvin3, Hoon Ji4, Jay Karajgikar4, Nancy Kim5, Shannon Chang6, Hersh Chandarana4, Sooah Kim4. 1. Department of Radiology, NYU Langone Health, New York, NY, 10016, USA. bari.dane@nyulangone.org. 2. Division of Biostatistics, NYU Langone Health, New York, NY, 10016, USA. 3. Department of Radiology, McGill University, Montreal, QC, H3G 1A4, USA. 4. Department of Radiology, NYU Langone Health, New York, NY, 10016, USA. 5. Department of Radiology, MedStar Georgetown University Hospital, Columbia, MD, 21044, USA. 6. Department of Gastroenterology, NYU Langone Health, New York, NY, 10016, USA.
Abstract
PURPOSE: To assess inter-reader agreement of key features from the SAR-AGA recommendations for the interpretation and reporting of MRE in adult patients with CD, focusing on the impact of radiologist experience on inter-reader agreement of CD phenotypes. METHODS: Two experienced and two less-experienced radiologists retrospectively evaluated 99 MRE in CD patients (50 initial MRE, 49 follow-up MRE) performed from 1/1/2019 to 3/20/2020 for the presence of active bowel inflammation (stomach, proximal small bowel, ileum, colon), stricture, probable stricture, penetrating disease, and perianal disease. The MRE protocol did not include dedicated perianal sequences. Inter-rater agreement was determined for each imaging feature using prevalence-adjusted bias-adjusted kappa and compared by experience level. RESULTS: All readers had almost-perfect inter-reader agreement (κ > 0.90) for penetrating disease, abscess, and perianal abscess in all 99 CD patients. All readers had strong inter-reader agreement (κ: 0.80-0.90) in 99 CD patients for active ileum inflammation, proximal small bowel inflammation, and stricture. Less-experienced readers had significantly lower inter-reader agreement for active ileum inflammation on initial than follow-up MRE (κ 0.68 versus 0.96, p = 0.018) and for strictures on follow-up than initial MRE (κ 0.76 versus 1.0, p = 0.027). Experienced readers had significantly lower agreement for perianal fistula on follow-up than initial MRE (κ: 0.55 versus 0.92, p = 0.008). CONCLUSION: There was strong to almost-perfect inter-reader agreement for key CD phenotypes described in the SAR-AGA consensus recommendations including active ileum and proximal small bowel inflammation, stricture, penetrating disease, abscess, and perianal abscess. Areas of lower inter-reader agreement could be targeted for future education efforts to further standardize CD MRE reporting. Dedicated perianal sequences should be included on follow-up MRE.
PURPOSE: To assess inter-reader agreement of key features from the SAR-AGA recommendations for the interpretation and reporting of MRE in adult patients with CD, focusing on the impact of radiologist experience on inter-reader agreement of CD phenotypes. METHODS: Two experienced and two less-experienced radiologists retrospectively evaluated 99 MRE in CD patients (50 initial MRE, 49 follow-up MRE) performed from 1/1/2019 to 3/20/2020 for the presence of active bowel inflammation (stomach, proximal small bowel, ileum, colon), stricture, probable stricture, penetrating disease, and perianal disease. The MRE protocol did not include dedicated perianal sequences. Inter-rater agreement was determined for each imaging feature using prevalence-adjusted bias-adjusted kappa and compared by experience level. RESULTS: All readers had almost-perfect inter-reader agreement (κ > 0.90) for penetrating disease, abscess, and perianal abscess in all 99 CD patients. All readers had strong inter-reader agreement (κ: 0.80-0.90) in 99 CD patients for active ileum inflammation, proximal small bowel inflammation, and stricture. Less-experienced readers had significantly lower inter-reader agreement for active ileum inflammation on initial than follow-up MRE (κ 0.68 versus 0.96, p = 0.018) and for strictures on follow-up than initial MRE (κ 0.76 versus 1.0, p = 0.027). Experienced readers had significantly lower agreement for perianal fistula on follow-up than initial MRE (κ: 0.55 versus 0.92, p = 0.008). CONCLUSION: There was strong to almost-perfect inter-reader agreement for key CD phenotypes described in the SAR-AGA consensus recommendations including active ileum and proximal small bowel inflammation, stricture, penetrating disease, abscess, and perianal abscess. Areas of lower inter-reader agreement could be targeted for future education efforts to further standardize CD MRE reporting. Dedicated perianal sequences should be included on follow-up MRE.
Authors: David H Bruining; Ellen M Zimmermann; Edward V Loftus; William J Sandborn; Cary G Sauer; Scott A Strong Journal: Radiology Date: 2018-01-10 Impact factor: 11.105
Authors: J Panes; Y Bouhnik; W Reinisch; J Stoker; S A Taylor; D C Baumgart; S Danese; S Halligan; B Marincek; C Matos; L Peyrin-Biroulet; J Rimola; G Rogler; G van Assche; S Ardizzone; A Ba-Ssalamah; M A Bali; D Bellini; L Biancone; F Castiglione; R Ehehalt; R Grassi; T Kucharzik; F Maccioni; G Maconi; F Magro; J Martín-Comín; G Morana; D Pendsé; S Sebastian; A Signore; D Tolan; J A Tielbeek; D Weishaupt; B Wiarda; A Laghi Journal: J Crohns Colitis Date: 2013-04-11 Impact factor: 9.071
Authors: David H Bruining; Ellen M Zimmermann; Edward V Loftus; William J Sandborn; Cary G Sauer; Scott A Strong Journal: Gastroenterology Date: 2018-01-10 Impact factor: 22.682
Authors: Peter C Church; Mary-Louise C Greer; Ruth Cytter-Kuint; Andrea S Doria; Anne M Griffiths; Dan Turner; Thomas D Walters; Brian M Feldman Journal: Pediatr Radiol Date: 2017-03-10
Authors: Jeroen A W Tielbeek; Jesica C Makanyanga; Shandra Bipat; Doug A Pendsé; C Yung Nio; Frans M Vos; Stuart A Taylor; Jaap Stoker Journal: AJR Am J Roentgenol Date: 2013-12 Impact factor: 3.959