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<meta name="DC.Title" content="Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3623" />
<meta name="DC.Date" content="2014-01-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Independent evaluation of angiographic images is becoming widely applied in the assessment of treatment outcomes of cerebral aneurysms. In the current study, we assessed the agreement between an independent core laboratory and the operators regarding angiographic appearance in a recent randomized, controlled trial.

MATERIALS AND METHODS: Data were derived from the Cerecyte Coil Trial. Angiographic images of each coiled aneurysm, taken immediately after embolization and at 5- to 7-month follow-up, were evaluated by the operator at the treating center and by an independent neuroradiologist at the core laboratory. For the purpose of this study, images were interpreted on a 3-point scale to provide uniformity for analysis; grade 1: complete occlusion, grade 2: neck remnant; and grade 3: sac filling. “Unfavorable angiographic appearance” was defined as grade 3 at follow-up or interval worsening of grade between the 2 time points.

RESULTS: The study included 434 aneurysms. Immediately after embolization, grade 3 was reported by operators in 39 (9%) compared with 52 (12%) by the core laboratory ( P = .159). On follow-up, grade 3 was reported by operators in 44 (10%) compared with 81 (19%) by the core laboratory ( P &lt; .0001). Overall, operators noted unfavorable angiographic appearance in 78 (18%) compared with 134 (31%) by the core laboratory ( P &lt; .0001). At every time point, agreement between the core laboratory and the operators was slight.

CONCLUSIONS: Unfavorable angiographic appearance was noted almost twice as frequently by an independent core laboratory as compared with the operators. Planning of trials and interpretation of published studies should be done with careful attention to the mode of angiographic appearance interpretation." />
<meta name="DC.Contributor" content="I. Rezek" />
<meta name="DC.Contributor" content="R.K. Lingineni" />
<meta name="DC.Contributor" content="M. Sneade" />
<meta name="DC.Contributor" content="A.J. Molyneux" />
<meta name="DC.Contributor" content="A.J. Fox" />
<meta name="DC.Contributor" content="D.F. Kallmes" />
<meta name="article:published_time" content="2014-01-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Independent evaluation of angiographic images is becoming widely applied in the assessment of treatment outcomes of cerebral aneurysms. In the current study, we assessed the agreement between an independent core laboratory and the operators regarding angiographic appearance in a recent randomized, controlled trial.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Data were derived from the Cerecyte Coil Trial. Angiographic images of each coiled aneurysm, taken immediately after embolization and at 5- to 7-month follow-up, were evaluated by the operator at the treating center and by an independent neuroradiologist at the core laboratory. For the purpose of this study, images were interpreted on a 3-point scale to provide uniformity for analysis; grade 1: complete occlusion, grade 2: neck remnant; and grade 3: sac filling. “Unfavorable angiographic appearance” was defined as grade 3 at follow-up or interval worsening of grade between the 2 time points.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The study included 434 aneurysms. Immediately after embolization, grade 3 was reported by operators in 39 (9%) compared with 52 (12%) by the core laboratory (&lt;i&gt;P&lt;/i&gt; = .159). On follow-up, grade 3 was reported by operators in 44 (10%) compared with 81 (19%) by the core laboratory (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). Overall, operators noted unfavorable angiographic appearance in 78 (18%) compared with 134 (31%) by the core laboratory (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). At every time point, agreement between the core laboratory and the operators was slight.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Unfavorable angiographic appearance was noted almost twice as frequently by an independent core laboratory as compared with the operators. Planning of trials and interpretation of published studies should be done with careful attention to the mode of angiographic appearance interpretation.&lt;/p&gt;" />
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<meta name="twitter:title" content="Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Independent evaluation of angiographic images is becoming widely applied in the assessment of treatment outcomes of cerebral aneurysms. In the current study, we assessed the agreement between an independent core laboratory and the operators regarding angiographic appearance in a recent randomized, controlled trial.

MATERIALS AND METHODS: Data were derived from the Cerecyte Coil Trial. Angiographic images of each coiled aneurysm, taken immediately after embolization and at 5- to 7-month follow-up, were evaluated by the operator at the treating center and by an independent neuroradiologist at the core laboratory. For the purpose of this study, images were interpreted on a 3-point scale to provide uniformity for analysis; grade 1: complete occlusion, grade 2: neck remnant; and grade 3: sac filling. “Unfavorable angiographic appearance” was defined as grade 3 at follow-up or interval worsening of grade between the 2 time points.

RESULTS: The study included 434 aneurysms. Immediately after embolization, grade 3 was reported by operators in 39 (9%) compared with 52 (12%) by the core laboratory ( P = .159). On follow-up, grade 3 was reported by operators in 44 (10%) compared with 81 (19%) by the core laboratory ( P &lt; .0001). Overall, operators noted unfavorable angiographic appearance in 78 (18%) compared with 134 (31%) by the core laboratory ( P &lt; .0001). At every time point, agreement between the core laboratory and the operators was slight.

CONCLUSIONS: Unfavorable angiographic appearance was noted almost twice as frequently by an independent core laboratory as compared with the operators. Planning of trials and interpretation of published studies should be done with careful attention to the mode of angiographic appearance interpretation." />
<meta name="og-title" property="og:title" content="Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Independent evaluation of angiographic images is becoming widely applied in the assessment of treatment outcomes of cerebral aneurysms. In the current study, we assessed the agreement between an independent core laboratory and the operators regarding angiographic appearance in a recent randomized, controlled trial.

MATERIALS AND METHODS: Data were derived from the Cerecyte Coil Trial. Angiographic images of each coiled aneurysm, taken immediately after embolization and at 5- to 7-month follow-up, were evaluated by the operator at the treating center and by an independent neuroradiologist at the core laboratory. For the purpose of this study, images were interpreted on a 3-point scale to provide uniformity for analysis; grade 1: complete occlusion, grade 2: neck remnant; and grade 3: sac filling. “Unfavorable angiographic appearance” was defined as grade 3 at follow-up or interval worsening of grade between the 2 time points.

RESULTS: The study included 434 aneurysms. Immediately after embolization, grade 3 was reported by operators in 39 (9%) compared with 52 (12%) by the core laboratory ( P = .159). On follow-up, grade 3 was reported by operators in 44 (10%) compared with 81 (19%) by the core laboratory ( P &lt; .0001). Overall, operators noted unfavorable angiographic appearance in 78 (18%) compared with 134 (31%) by the core laboratory ( P &lt; .0001). At every time point, agreement between the core laboratory and the operators was slight.

CONCLUSIONS: Unfavorable angiographic appearance was noted almost twice as frequently by an independent core laboratory as compared with the operators. Planning of trials and interpretation of published studies should be done with careful attention to the mode of angiographic appearance interpretation." />
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      <h1 class="highwire-cite-title" id="page-title">Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">I. Rezek</span>, <span class="highwire-citation-author" data-delta="1">R.K. Lingineni</span>, <span class="highwire-citation-author" data-delta="2">M. Sneade</span>, <span class="highwire-citation-author" data-delta="3">A.J. Molyneux</span>, <span class="highwire-citation-author" data-delta="4">A.J. Fox</span> and <span class="highwire-citation-author" data-delta="5">D.F. Kallmes</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">124-127; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3623 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12755--6344525241" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">I. Rezek </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (I.R., D.F.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=I.%2BRezek%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rezek%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AI.%2BRezek%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">R.K. Lingineni </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Health Sciences Research (R.K.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.K.%2BLingineni%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lingineni%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.K.%2BLingineni%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Sneade </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Oxford Neurovascular and Neuroradiology Research Unit (M.S., A.J.M.), Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BSneade%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sneade%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BSneade%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A.J. Molyneux </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Oxford Neurovascular and Neuroradiology Research Unit (M.S., A.J.M.), Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.J.%2BMolyneux%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Molyneux%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.J.%2BMolyneux%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A.J. Fox </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neuroradiology (A.J.F.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.J.%2BFox%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fox%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.J.%2BFox%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D.F. Kallmes </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (I.R., D.F.K.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurosurgery (D.F.K.), Mayo Clinic, Rochester, Minnesota</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.F.%2BKallmes%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kallmes%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.F.%2BKallmes%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Independent evaluation of angiographic images is becoming widely applied in the assessment of treatment outcomes of cerebral aneurysms. In the current study, we assessed the agreement between an independent core laboratory and the operators regarding angiographic appearance in a recent randomized, controlled trial.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> Data were derived from the Cerecyte Coil Trial. Angiographic images of each coiled aneurysm, taken immediately after embolization and at 5- to 7-month follow-up, were evaluated by the operator at the treating center and by an independent neuroradiologist at the core laboratory. For the purpose of this study, images were interpreted on a 3-point scale to provide uniformity for analysis; grade 1: complete occlusion, grade 2: neck remnant; and grade 3: sac filling. “Unfavorable angiographic appearance” was defined as grade 3 at follow-up or interval worsening of grade between the 2 time points.</p>
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<p id="p-3"><strong>RESULTS:</strong> The study included 434 aneurysms. Immediately after embolization, grade 3 was reported by operators in 39 (9%) compared with 52 (12%) by the core laboratory (<em>P</em> = .159). On follow-up, grade 3 was reported by operators in 44 (10%) compared with 81 (19%) by the core laboratory (<em>P</em> &lt; .0001). Overall, operators noted unfavorable angiographic appearance in 78 (18%) compared with 134 (31%) by the core laboratory (<em>P</em> &lt; .0001). At every time point, agreement between the core laboratory and the operators was slight.</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> Unfavorable angiographic appearance was noted almost twice as frequently by an independent core laboratory as compared with the operators. Planning of trials and interpretation of published studies should be done with careful attention to the mode of angiographic appearance interpretation.</p>
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Rezek</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">R.K.</span> <span class="nlm-surname">Lingineni</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Sneade</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Molyneux</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Fox</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.F.</span> <span class="nlm-surname">Kallmes</span></span></span></div>
  
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      <div class="highwire-cite-title">Differences in the Angiographic Evaluation of Coiled Cerebral Aneurysms between a Core Laboratory Reader and Operators: Results of the Cerecyte Coil Trial</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Rezek</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">R.K.</span> <span class="nlm-surname">Lingineni</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Sneade</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Molyneux</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Fox</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.F.</span> <span class="nlm-surname">Kallmes</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">124-127; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3623 </span></div>
  
  
  
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