J 2022

Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography

OSPEL, J. M., F. BALA, R. V. MCDONOUGH, Ondřej VOLNÝ, N. KASHANI et. al.

Basic information

Original name

Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography

Authors

OSPEL, J. M., F. BALA, R. V. MCDONOUGH, Ondřej VOLNÝ (203 Czech Republic, belonging to the institution), N. KASHANI, W.. QIU, B. K. MENON and M. GOYAL (guarantor)

Edition

American Journal of Neuroradiology, Denville, American Society of Neuroradiology, 2022, 0195-6108

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.500

RIV identification code

RIV/00216224:14110/22:00125091

Organization unit

Faculty of Medicine

DOI

UT WoS

000722313700001

Keywords in English

Medium-Vessel Occlusions; Single-Phase and Multiphase CT Angiography

Tags

Tags

International impact, Reviewed
Změněno: 14/3/2023 08:44, Mgr. Tereza Miškechová

Abstract

V originále

BACKGROUND AND PURPOSE: Accurate and reliable detection of medium-vessel occlusions is important to establish the diagnosis of acute ischemic stroke and initiate appropriate treatment with intravenous thrombolysis or endovascular thrombectomy. However, medium-vessel occlusions are often challenging to detect, especially for unexperienced readers. We aimed to evaluate the accuracy and interrater agreement of the detection of medium-vessel occlusions using single-phase and multiphase CTA. MATERIALS AND METHODS: Single-phase and multiphase CTA of 120 patients with acute ischemic stroke (20 with no occlusion, 44 with large-vessel occlusion, and 56 with medium-vessel occlusion in the anterior and posterior circulation) were assessed by 3 readers with varying levels of experience (session 1: single-phase CTA; session 2: multiphase CTA). Interrater agreement for occlusion type (large-vessel occlusion versus medium-vessel occlusion versus no occlusion) and for detailed occlusion sites was calculated using the Fleiss ? with 95% confidence intervals. Accuracy for the detection of medium-vessel occlusions was calculated for each reader using classification tables. RESULTS: Interrater agreement for occlusion type was moderate for single-phase CTA (? ?=?0.58; 95% CI, 0.56?0.62) and almost perfect for multiphase CTA (? = 0.81; 95% CI, 0.78?0.83). Interrater agreement for detailed occlusion sites was moderate for single-phase CTA (? = 0.55; 95% CI, 0.53?0.56) and substantial for multiphase CTA (? = 0.71; 95% CI, 0.67?0.74). On single-phase CTA, readers 1, 2, and 3 classified 33/56 (59%), 34/56 (61%), and 32/56 (57%) correctly as medium-vessel occlusions. On multiphase CTA, 48/56 (86%), 50/56 (89%), and 50/56 (89%) medium-vessel occlusions were classified correctly. CONCLUSIONS: Interrater agreement for medium-vessel occlusions is moderate when using single-phase CTA and almost perfect with multiphase CTA. Detection accuracy is substantially higher with multiphase CTA compared with single-phase CTA, suggesting that multiphase CTA might be a valuable tool for assessment of medium-vessel occlusion stroke.