Dataset Information

Interobserver agreement for the direct and indirect signs of pulmonary embolism evaluated using contrast enhanced magnetic angiography.

ABSTRACT: Background:Accurate diagnosis of pulmonary embolism (PE) using contrast enhanced MRA (CE-MRA) requires awareness of both the direct and indirect findings of PE. Purpose:To evaluate reader agreement of the direct and indirect findings of PE on CE-MRA. Methods:We evaluated pulmonary artery diameter, right ventricle/left ventricle ratio, and clot/vessel lumen signal intensity ratio. Also, eight direct and eight indirect findings of PE were interpreted twice by two radiologists with different experience levels. The prevalence, and intra- and inter-reader agreement for the direct and indirect findings of PE were recorded. Statistical analysis of the measurements was assessed using intraclass correlation while Cohen's kappa test determined inter- and intra-reader agreement. Results:We reviewed 66 positive CE-MRA exams, 10 of which cases were used for training. The largest PE for each of the remaining 56 cases (40 woman) were included in this analysis (38.9 ± 19.7 (mean age (years) ± S.D.)). The highest interobserver agreement for the direct findings were vessel cutoff (? = 0.52, 95 % CI = (0.30, 0.74), p < .0001) and bright clot (? = 0.51, 95 % CI = (0.26, 0.78), p = .0001). The highest interobserver agreement for the indirect findings were for atelectasis (? = 0.67, 95 % CI = (0.49, 0.87), p < .0001), pleural effusions (? = 0.56, 95 % CI = (0.32, 0.79), p = 0001) and blank slate sing (? = 0.56, 95 % CI = (0.18, 0.94), p < .0001). Conclusion:The indirect findings of atelectasis and pleural effusion had better interobserver reproducibility than the direct findings of vessel cutoff and bright clot. The intraobserver reproducibility of the direct and indirect findings is dependent on experience level. Summary statement:Using contrast enhanced magnetic resonance angiography for the diagnosis of pulmonary embolism, the indirect findings of atelectasis and pleural effusion had better interobserver reproducibility than the direct findings of vessel cutoff and bright clot.

SUBMITTER: Tsuchiya N

PROVIDER: S-EPMC7494795 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Interobserver agreement for the direct and indirect signs of pulmonary embolism evaluated using contrast enhanced magnetic angiography.

Tsuchiya Nanae N Benson Donald G DG Longhurst Colin C François Christopher J CJ Reeder Scott B SB Repplinger Michael D MD Schiebler Mark L ML

European journal of radiology open 20200910

<h4>Background</h4>Accurate diagnosis of pulmonary embolism (PE) using contrast enhanced MRA (CE-MRA) requires awareness of both the direct and indirect findings of PE.<h4>Purpose</h4>To evaluate reader agreement of the direct and indirect findings of PE on CE-MRA.<h4>Methods</h4>We evaluated pulmonary artery diameter, right ventricle/left ventricle ratio, and clot/vessel lumen signal intensity ratio. Also, eight direct and eight indirect findings of PE were interpreted twice by two radiologists ...[more]

PMID: 32984448

Similar Datasets

Project description:ObjectiveTo evaluate interobserver agreement for the assessment of local tumor extension in women with cervical cancer, among experienced and less experienced observers, using transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI).MethodsThe TVS observers were all gynecologists and consultant ultrasound specialists, six with and seven without previous experience in cervical cancer imaging. The MRI observers were five radiologists experienced in pelvic MRI and four less experienced radiology residents without previous experience in MRI of the pelvis. The less experienced TVS observers and all MRI observers underwent a short basic training session in the assessment of cervical tumor extension, while the experienced TVS observers received only a written directive. All observers were assigned the same images from cervical cancer patients at all stages (n = 60) and performed offline evaluation to answer the following three questions: (1) Is there a visible primary tumor? (2) Does the tumor infiltrate > ⅓ of the cervical stroma? and (3) Is there parametrial invasion? Interobserver agreement within the four groups of observers was assessed using Fleiss kappa (κ) with 95% CI.ResultsExperienced and less experienced TVS observers, respectively, had moderate interobserver agreement with respect to tumor detection (κ (95% CI), 0.46 (0.40-0.53) and 0.46 (0.41-0.52)), stromal invasion > ⅓ (κ (95% CI), 0.45 (0.38-0.51) and 0.53 (0.40-0.58)) and parametrial invasion (κ (95% CI), 0.57 (0.51-0.64) and 0.44 (0.39-0.50)). Experienced MRI observers had good interobserver agreement with respect to tumor detection (κ (95% CI), 0.70 (0.62-0.78)), while less experienced MRI observers had moderate agreement (κ (95% CI), 0.51 (0.41-0.62)), and both experienced and less experienced MRI observers, respectively, had good interobserver agreement regarding stromal invasion (κ (95% CI), 0.80 (0.72-0.88) and 0.71 (0.61-0.81)) and parametrial invasion (κ (95% CI), 0.69 (0.61-0.77) and 0.71 (0.61-0.81)).ConclusionsWe found interobserver agreement for the assessment of local tumor extension in patients with cervical cancer to be moderate for TVS and moderate-to-good for MRI. The level of interobserver agreement was associated with experience among TVS observers only for parametrial invasion. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Project description:BackgroundThe accuracy of gadolinium-enhanced magnetic resonance pulmonary angiography and magnetic resonance venography for diagnosing pulmonary embolism has not been determined conclusively.ObjectiveTo investigate performance characteristics of magnetic resonance angiography, with or without magnetic resonance venography, for diagnosing pulmonary embolism.DesignProspective, multicenter study from 10 April 2006 to 30 September 2008.Setting7 hospitals and their emergency services.Patients371 adults with diagnosed or excluded pulmonary embolism.MeasurementsSensitivity, specificity, and likelihood ratios were measured by comparing independently read magnetic resonance imaging with the reference standard for diagnosing pulmonary embolism. Reference standard diagnosis or exclusion was made by using various tests, including computed tomographic angiography and venography, ventilation-perfusion lung scan, venous ultrasonography, d-dimer assay, and clinical assessment.ResultsMagnetic resonance angiography, averaged across centers, was technically inadequate in 25% of patients (92 of 371). The proportion of technically inadequate images ranged from 11% to 52% at various centers. Including patients with technically inadequate images, magnetic resonance angiography identified 57% (59 of 104) with pulmonary embolism. Technically adequate magnetic resonance angiography had a sensitivity of 78% and a specificity of 99%. Technically adequate magnetic resonance angiography and venography had a sensitivity of 92% and a specificity of 96%, but 52% of patients (194 of 370) had technically inadequate results.LimitationA high proportion of patients with suspected embolism was not eligible or declined to participate.ConclusionMagnetic resonance pulmonary angiography should be considered only at centers that routinely perform it well and only for patients for whom standard tests are contraindicated. Magnetic resonance pulmonary angiography and magnetic resonance venography combined have a higher sensitivity than magnetic resonance pulmonary angiography alone in patients with technically adequate images, but it is more difficult to obtain technically adequate images with the 2 procedures.

Dataset Information

Interobserver agreement for the direct and indirect signs of pulmonary embolism evaluated using contrast enhanced magnetic angiography.

Publications

Interobserver agreement for the direct and indirect signs of pulmonary embolism evaluated using contrast enhanced magnetic angiography.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets