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PT  - JOURNAL ARTICLE
AU  - Jamali, S.
AU  - Fahed, R.
AU  - Gentric, J.-C.
AU  - Letourneau-Guillon, L.
AU  - Raoult, H.
AU  - Bing, F.
AU  - Estrade, L.
AU  - Nguyen, T.N.
AU  - Tollard, É.
AU  - Ferre, J.-C.
AU  - Iancu, D.
AU  - Naggara, O.
AU  - Chagnon, M.
AU  - Weill, A.
AU  - Roy, D.
AU  - Fox, A.J.
AU  - Kallmes, D.F.
AU  - Raymond, J.
TI  - Inter- and Intrarater Agreement on the Outcome of Endovascular Treatment of Aneurysms Using MRA
AID  - 10.3174/ajnr.A4609
DP  - 2016 May 01
TA  - American Journal of Neuroradiology
PG  - 879--884
VI  - 37
IP  - 5
4099  - http://www.ajnr.org/content/37/5/879.short
4100  - http://www.ajnr.org/content/37/5/879.full
SO  - Am. J. Neuroradiol.2016 May 01; 37
AB  - BACKGROUND AND PURPOSE: Patients treated with coiling are often followed by MR angiography. Our objective was to assess the inter- and intraobserver agreement in diagnosing aneurysm remnants and recurrences by using multimodality imaging, including TOF MRA.MATERIALS AND METHODS: A portfolio composed of 120 selected images from 56 patients was sent to 15 neuroradiologists from 10 institutions. For each case, raters were asked to classify angiographic results (3 classes) of 2 studies (32 MRA-MRA and 24 DSA-MRA pairs) and to provide a final judgment regarding the presence of a recurrence (no, minor, major). Six raters were asked to independently review the portfolio twice. A second study, restricted to 4 raters having full access to all images, was designed to validate the results of the electronic survey.RESULTS: The proportion of cases judged to have a major recurrence varied between 16.1% and 71.4% (mean, 35.0% ± 12.7%). There was moderate agreement overall (κ = 0.474 ± 0.009), increasing to nearly substantial (κ = 0.581 ± 0.014) when the judgment was dichotomized (presence or absence of a major recurrence). Agreement on cases followed-up by MRA-MRA was similarly substantial (κ = 0.601 ± 0.018). The intrarater agreement varied between fair (κ = 0.257 ± 0.093) and substantial (κ= 0.699 ± 0.084), improving with a dichotomized judgment concerning MRA-MRA comparisons. Agreement was no better when raters had access to all images.CONCLUSIONS: There is an important variability in the assessment of angiographic outcomes of endovascular treatments. Agreement on the presence of a major recurrence when comparing 2 MRA studies or the MRA with the last catheter angiographic study can be substantial.