Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study
Rationale and Objective: Thoracic CT angiography (CTA) for ascending aortic dissection, a life-threatening emergency, is performed routinely without Electrocardiographic (ECG) gating, therefore allowing the apparition of a pulsation artefact. We aimed to evaluate and compare the diagnostic performan...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/8/5/201 |
| _version_ | 1797469768292237312 |
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| author | Razvan G. Budeanu Christian Broemmer Anamaria R. Budeanu Marian Pop |
| author_facet | Razvan G. Budeanu Christian Broemmer Anamaria R. Budeanu Marian Pop |
| author_sort | Razvan G. Budeanu |
| collection | DOAJ |
| description | Rationale and Objective: Thoracic CT angiography (CTA) for ascending aortic dissection, a life-threatening emergency, is performed routinely without Electrocardiographic (ECG) gating, therefore allowing the apparition of a pulsation artefact. We aimed to evaluate and compare the diagnostic performance, the inter and intra-reporter agreement of ECG gated CTA and non-ECG gated CTA for detecting ascending aortic dissection, considering their training level. Our hypothesis is that ECG gated CTA has superior diagnostic accuracy for ascending aortic dissection compared to non-gated CTA. Materials and Methods: We collected data using 24 questions survey using clinically validated CT examinations. Sixty-six respondents (medical students, radiology residents, and consultants) blinded to the actual diagnosis independently evaluated the images pertaining to the presence of ascending aortic dissection. The reference standard was represented by clinical and imaging diagnosis. Inter-rater and inter-group concordance was evaluated; the agreement with reference tests was calculated and assessed as a function of reporters’ training level. Results: Reporters’ ascending aortic dissection assessment showed a better correlation with the reference standard in the ECG gated CTA. The inter-rater correlation was higher in the ECG gated CTA compared to non-ECG gated CTA. Observers’ confidence for diagnosing ascending aortic dissection was higher in the ECG gated CTA. Statistically significant differences (<i>p</i> < 0.05) were found between different training levels when assessing non-ECG gated examinations. Conclusions: ECG gated CTA shows a higher diagnostic performance for ascending aortic dissection than non-ECG gated CTA, regardless of the reporters’ training level. |
| first_indexed | 2024-03-09T19:25:50Z |
| format | Article |
| id | doaj.art-6e050057f68e421baca99d076a712bac |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-09T19:25:50Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-6e050057f68e421baca99d076a712bac2023-11-24T02:56:30ZengMDPI AGTomography2379-13812379-139X2022-09-01852426243410.3390/tomography8050201Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS StudyRazvan G. Budeanu0Christian Broemmer1Anamaria R. Budeanu2Marian Pop3Emergency County Hospital Târgu Mureș, 540136 Targu Mures, RomaniaME1 Department, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, RomaniaEmergency County Hospital Târgu Mureș, 540136 Targu Mures, RomaniaME1 Department, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, RomaniaRationale and Objective: Thoracic CT angiography (CTA) for ascending aortic dissection, a life-threatening emergency, is performed routinely without Electrocardiographic (ECG) gating, therefore allowing the apparition of a pulsation artefact. We aimed to evaluate and compare the diagnostic performance, the inter and intra-reporter agreement of ECG gated CTA and non-ECG gated CTA for detecting ascending aortic dissection, considering their training level. Our hypothesis is that ECG gated CTA has superior diagnostic accuracy for ascending aortic dissection compared to non-gated CTA. Materials and Methods: We collected data using 24 questions survey using clinically validated CT examinations. Sixty-six respondents (medical students, radiology residents, and consultants) blinded to the actual diagnosis independently evaluated the images pertaining to the presence of ascending aortic dissection. The reference standard was represented by clinical and imaging diagnosis. Inter-rater and inter-group concordance was evaluated; the agreement with reference tests was calculated and assessed as a function of reporters’ training level. Results: Reporters’ ascending aortic dissection assessment showed a better correlation with the reference standard in the ECG gated CTA. The inter-rater correlation was higher in the ECG gated CTA compared to non-ECG gated CTA. Observers’ confidence for diagnosing ascending aortic dissection was higher in the ECG gated CTA. Statistically significant differences (<i>p</i> < 0.05) were found between different training levels when assessing non-ECG gated examinations. Conclusions: ECG gated CTA shows a higher diagnostic performance for ascending aortic dissection than non-ECG gated CTA, regardless of the reporters’ training level.https://www.mdpi.com/2379-139X/8/5/201inter-rater reliabilityradiologyECG-gatedCTAascending aortic dissection |
| spellingShingle | Razvan G. Budeanu Christian Broemmer Anamaria R. Budeanu Marian Pop Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study Tomography inter-rater reliability radiology ECG-gated CTA ascending aortic dissection |
| title | Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study |
| title_full | Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study |
| title_fullStr | Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study |
| title_full_unstemmed | Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study |
| title_short | Comparing the Diagnostic Performance of ECG Gated versus Non-Gated CT Angiography in Ascending Aortic Dissection: A GRRAS Study |
| title_sort | comparing the diagnostic performance of ecg gated versus non gated ct angiography in ascending aortic dissection a grras study |
| topic | inter-rater reliability radiology ECG-gated CTA ascending aortic dissection |
| url | https://www.mdpi.com/2379-139X/8/5/201 |
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