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@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 = {http://dx.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://dx.doi.org/10.3174/ajnr.A7361.
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