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Inter-modality assessment of medial temporal lobe atrophy in a non-demented population : application of a visual rating scale template across radiologists with varying clinical experience

Håkansson, Claes LU ; Tamaddon, Ashkan LU ; Andersson, Henrik LU orcid ; Torisson, Gustav LU orcid ; Mårtensson, Gustav ; Truong, My LU orcid ; Annertz, Mårten LU ; Londos, Elisabet LU ; Björkman-Burtscher, Isabella M. LU and Hansson, Oskar LU orcid , et al. (2022) In European Radiology 32(2). p.1127-1134
Abstract

Objectives: To assess inter-modality agreement and accuracy for medial temporal lobe atrophy (MTA) ratings across radiologists with varying clinical experience in a non-demented population. Methods: Four raters (two junior radiologists and two senior neuroradiologists) rated MTA on CT and MRI scans using Scheltens’ MTA scale. Ratings were compared to a consensus rating by two experienced neuroradiologists for estimation of true positive and negative rates (TPR and TNR) and over- and underestimation of MTA. Inter-modality agreement expressed as Cohen’s κ (dichotomized data), Cohen’s κw, and two-way mixed, single measures, consistency ICC (ordinal data) were determined. Adequate agreement was defined as κ/κw ≥ 0.80... (More)

Objectives: To assess inter-modality agreement and accuracy for medial temporal lobe atrophy (MTA) ratings across radiologists with varying clinical experience in a non-demented population. Methods: Four raters (two junior radiologists and two senior neuroradiologists) rated MTA on CT and MRI scans using Scheltens’ MTA scale. Ratings were compared to a consensus rating by two experienced neuroradiologists for estimation of true positive and negative rates (TPR and TNR) and over- and underestimation of MTA. Inter-modality agreement expressed as Cohen’s κ (dichotomized data), Cohen’s κw, and two-way mixed, single measures, consistency ICC (ordinal data) were determined. Adequate agreement was defined as κ/κw ≥ 0.80 and ICC ≥ 0.80 (significance level at 95% CI ≥ 0.65). Results: Forty-nine subjects (median age 72 years, 27% abnormal MTA) with cognitive impairment were included. Only junior radiologists achieved adequate agreement expressed as Cohen’s κ. All raters achieved adequate agreement expressed as Cohen’s κw and ICC. True positive rates varied from 69 to 100% and TNR varied from 85 to 100%. No under- or overestimation of MTA was observed. Ratings did not differ between radiologists. Conclusion: We conclude that radiologists with varying experience achieve adequate inter-modality agreement and similar accuracy when Scheltens’ MTA scale is used to rate MTA on a non-demented population. However, TPR varied between radiologists which could be attributed to rating style differences. Key Points: • Radiologists with varying experience achieve adequate inter-modality agreement with similar accuracy when Scheltens’ MTA scale is used to rate MTA on a non-demented population. • Differences in rating styles might affect accuracy, this was most evident for senior neuroradiologists, and only junior radiologists achieved adequate agreement on dichotomized (abnormal/normal) ratings. • The use of an MTA scale template might compensate for varying clinical experience which could make it applicable for clinical use.

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organization
publishing date
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Contribution to journal
publication status
published
subject
keywords
Cognitive dysfunction, Consensus, Magnetic resonance imaging, Radiologists, Tomography, X-ray computed
in
European Radiology
volume
32
issue
2
pages
1127 - 1134
publisher
Springer
external identifiers
  • pmid:34328536
  • scopus:85111476173
ISSN
0938-7994
DOI
10.1007/s00330-021-08177-1
language
English
LU publication?
yes
id
3bb134c6-c599-44e7-948b-62e12eaa9adc
date added to LUP
2021-08-31 11:20:36
date last changed
2024-04-20 11:27:06
@article{3bb134c6-c599-44e7-948b-62e12eaa9adc,
  abstract     = {{<p>Objectives: To assess inter-modality agreement and accuracy for medial temporal lobe atrophy (MTA) ratings across radiologists with varying clinical experience in a non-demented population. Methods: Four raters (two junior radiologists and two senior neuroradiologists) rated MTA on CT and MRI scans using Scheltens’ MTA scale. Ratings were compared to a consensus rating by two experienced neuroradiologists for estimation of true positive and negative rates (TPR and TNR) and over- and underestimation of MTA. Inter-modality agreement expressed as Cohen’s κ (dichotomized data), Cohen’s κ<sub>w</sub>, and two-way mixed, single measures, consistency ICC (ordinal data) were determined. Adequate agreement was defined as κ/κ<sub>w</sub> ≥ 0.80 and ICC ≥ 0.80 (significance level at 95% CI ≥ 0.65). Results: Forty-nine subjects (median age 72 years, 27% abnormal MTA) with cognitive impairment were included. Only junior radiologists achieved adequate agreement expressed as Cohen’s κ. All raters achieved adequate agreement expressed as Cohen’s κ<sub>w</sub> and ICC. True positive rates varied from 69 to 100% and TNR varied from 85 to 100%. No under- or overestimation of MTA was observed. Ratings did not differ between radiologists. Conclusion: We conclude that radiologists with varying experience achieve adequate inter-modality agreement and similar accuracy when Scheltens’ MTA scale is used to rate MTA on a non-demented population. However, TPR varied between radiologists which could be attributed to rating style differences. Key Points: • Radiologists with varying experience achieve adequate inter-modality agreement with similar accuracy when Scheltens’ MTA scale is used to rate MTA on a non-demented population. • Differences in rating styles might affect accuracy, this was most evident for senior neuroradiologists, and only junior radiologists achieved adequate agreement on dichotomized (abnormal/normal) ratings. • The use of an MTA scale template might compensate for varying clinical experience which could make it applicable for clinical use.</p>}},
  author       = {{Håkansson, Claes and Tamaddon, Ashkan and Andersson, Henrik and Torisson, Gustav and Mårtensson, Gustav and Truong, My and Annertz, Mårten and Londos, Elisabet and Björkman-Burtscher, Isabella M. and Hansson, Oskar and van Westen, Danielle}},
  issn         = {{0938-7994}},
  keywords     = {{Cognitive dysfunction; Consensus; Magnetic resonance imaging; Radiologists; Tomography, X-ray computed}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{1127--1134}},
  publisher    = {{Springer}},
  series       = {{European Radiology}},
  title        = {{Inter-modality assessment of medial temporal lobe atrophy in a non-demented population : application of a visual rating scale template across radiologists with varying clinical experience}},
  url          = {{http://dx.doi.org/10.1007/s00330-021-08177-1}},
  doi          = {{10.1007/s00330-021-08177-1}},
  volume       = {{32}},
  year         = {{2022}},
}