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

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

Article in a journal

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 3.500

RIV identification code

RIV/00216224:14110/22:00125091

Organization unit

Faculty of Medicine

DOI

https://doi.org/10.3174/ajnr.A7361

UT WoS

000722313700001

EID Scopus

2-s2.0-85123651406

Keywords in English

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

Abstract

In the original language

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.

Cite

OSPEL, J. M.; F. BALA; R. V. MCDONOUGH; Ondřej VOLNÝ; N. KASHANI; W.. QIU; B. K. MENON and M. GOYAL. Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography. American Journal of Neuroradiology. Denville: American Society of Neuroradiology, 2022, vol. 43, No 1, p. 93-97. ISSN 0195-6108. Available from: https://doi.org/10.3174/ajnr.A7361.

@article{1809817,
   author = {Ospel, J. M. and Bala, F. and McDonough, R. V. and Volný, Ondřej and Kashani, N. and Qiu, W.. and Menon, B. K. and Goyal, M.},
   article_location = {Denville},
   article_number = {1},
   doi = {https://doi.org/10.3174/ajnr.A7361},
   keywords = {Medium-Vessel Occlusions; Single-Phase and Multiphase CT Angiography},
   language = {eng},
   issn = {0195-6108},
   journal = {American Journal of Neuroradiology},
   title = {Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography},
   url = {http://www.ajnr.org/content/early/2021/11/25/ajnr.A7361},
   volume = {43},
   year = {2022}
}

TY  - JOUR
ID  - 1809817
AU  - Ospel, J. M. - Bala, F. - McDonough, R. V. - Volný, Ondřej - Kashani, N. - Qiu, W.. - Menon, B. K. - Goyal, M.
PY  - 2022
TI  - Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography
JF  - American Journal of Neuroradiology
VL  - 43
IS  - 1
SP  - 93-97
EP  - 93-97
PB  - American Society of Neuroradiology
SN  - 01956108
KW  - Medium-Vessel Occlusions
KW  - Single-Phase and Multiphase CT Angiography
UR  - http://www.ajnr.org/content/early/2021/11/25/ajnr.A7361
N2  - 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.
ER  -

OSPEL, J. M.; F. BALA; R. V. MCDONOUGH; Ondřej VOLNÝ; N. KASHANI; W.. QIU; B. K. MENON and M. GOYAL. Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography. \textit{American Journal of Neuroradiology}. Denville: American Society of Neuroradiology, 2022, vol.~43, No~1, p.~93-97. ISSN~0195-6108. Available from: https://doi.org/10.3174/ajnr.A7361.

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