PURPOSE: To investigate the time and effort needed to perform vertebral morphometry, as well as inter-observer agreement for identification of vertebral fractures on vertebral fracture assessment (VFA) images. METHODS: Ninety-six images were retrospectively selected, and three radiographers independently performed semi-automatic 6-point morphometry. Fractures were identified and graded using the Genant classification. Time needed to annotate each image was recorded, and reader fatigue was assessed using a modified Simulator Sickness Questionnaire (SSQ). Inter-observer agreement was assessed per-patient and per-vertebra for detecting fractures of all grades (grades 1-3) and for grade 2 and 3 fractures using the kappa statistic. Variability in measured vertebral height was evaluated using the intraclass correlation coefficient (ICC). RESULTS: Per-patient agreement was 0.59 for grades 1-3 fracture detection, and 0.65 for grades 2-3 only. Agreement for per-vertebra fracture classification was 0.92. Vertebral height measurements had an ICC of 0.96. Time needed to annotate VFA images ranged between 91 and 540 s, with a mean annotation time of 259 s. Mean SSQ scores were significantly lower at the start of a reading session (1.29; 95% CI: 0.81-1.77) compared to the end of a session (3.25; 95% CI: 2.60-3.90; p < 0.001). CONCLUSION: Agreement for detection of patients with vertebral fractures was only moderate, and vertebral morphometry requires substantial time investment. This indicates that there is a potential benefit for automating VFA, both in improving inter-observer agreement and in decreasing reading time and burden on readers.
PURPOSE: To investigate the time and effort needed to perform vertebral morphometry, as well as inter-observer agreement for identification of vertebral fractures on vertebral fracture assessment (VFA) images. METHODS: Ninety-six images were retrospectively selected, and three radiographers independently performed semi-automatic 6-point morphometry. Fractures were identified and graded using the Genant classification. Time needed to annotate each image was recorded, and reader fatigue was assessed using a modified Simulator Sickness Questionnaire (SSQ). Inter-observer agreement was assessed per-patient and per-vertebra for detecting fractures of all grades (grades 1-3) and for grade 2 and 3 fractures using the kappa statistic. Variability in measured vertebral height was evaluated using the intraclass correlation coefficient (ICC). RESULTS: Per-patient agreement was 0.59 for grades 1-3 fracture detection, and 0.65 for grades 2-3 only. Agreement for per-vertebra fracture classification was 0.92. Vertebral height measurements had an ICC of 0.96. Time needed to annotate VFA images ranged between 91 and 540 s, with a mean annotation time of 259 s. Mean SSQ scores were significantly lower at the start of a reading session (1.29; 95% CI: 0.81-1.77) compared to the end of a session (3.25; 95% CI: 2.60-3.90; p < 0.001). CONCLUSION: Agreement for detection of patients with vertebral fractures was only moderate, and vertebral morphometry requires substantial time investment. This indicates that there is a potential benefit for automating VFA, both in improving inter-observer agreement and in decreasing reading time and burden on readers.
Authors: A A Ismail; W Cockerill; C Cooper; J D Finn; K Abendroth; G Parisi; D Banzer; L I Benevolenskaya; A K Bhalla; J B Armas; J B Cannata; P D Delmas; J Dequeker; G Dilsen; R Eastell; O Ershova; J A Falch; B Felsch; S Havelka; K Hoszowski; I Jajic; U Kragl; O Johnell; A Lopez Vaz; R Lorenc; G Lyritis; F Marchand; P Masaryk; C Matthis; T Miazgowski; H A Pols; G Poor; A Rapado; H H Raspe; D M Reid; W Reisinger; J Janott; C Scheidt-Nave; J Stepan; C Todd; K Weber; A D Woolf; G Ambrecht; W Gowin; D Felsenberg; M Lunt; J A Kanis; J Reeve; A J Silman; T W O'Neill Journal: Osteoporos Int Date: 2001 Impact factor: 4.507
Authors: D Felsenberg; A J Silman; M Lunt; G Armbrecht; A A Ismail; J D Finn; W C Cockerill; D Banzer; L I Benevolenskaya; A Bhalla; J Bruges Armas; J B Cannata; C Cooper; J Dequeker; R Eastell; B Felsch; W Gowin; S Havelka; K Hoszowski; I Jajic; J Janott; O Johnell; J A Kanis; G Kragl; A Lopes Vaz; R Lorenc; G Lyritis; P Masaryk; C Matthis; T Miazgowski; G Parisi; H A P Pols; G Poor; H H Raspe; D M Reid; W Reisinger; C Schedit-Nave; J J Stepan; C J Todd; K Weber; A D Woolf; O B Yershova; J Reeve; T W O'Neill Journal: J Bone Miner Res Date: 2002-04 Impact factor: 6.741
Authors: R Lindsay; S L Silverman; C Cooper; D A Hanley; I Barton; S B Broy; A Licata; L Benhamou; P Geusens; K Flowers; H Stracke; E Seeman Journal: JAMA Date: 2001-01-17 Impact factor: 56.272
Authors: Jane A Cauley; Marc C Hochberg; Li-Yung Lui; Lisa Palermo; Kristine E Ensrud; Teresa A Hillier; Michael C Nevitt; Steven R Cummings Journal: JAMA Date: 2007-12-19 Impact factor: 56.272