Learning imaging in axial spondyloarthritis: more than just a matter of experience
Objective Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT.Methods This post hoc analysis inclu...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-02-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/10/1/e003944.full |
| _version_ | 1797222055538589696 |
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| author | Denis Poddubnyy Torsten Diekhoff Sevtap Tugce Ulas Robert Biesen Hildrun Haibel Iris Eshed Fabian Proft Mikhail Protopopov Valeria Rios Rodriguez Judith Rademacher Juliane Greese Dominik Deppe Felix Radny Katharina Ziegeler Kay Geert A Hermann Carsten Stelbrink |
| author_facet | Denis Poddubnyy Torsten Diekhoff Sevtap Tugce Ulas Robert Biesen Hildrun Haibel Iris Eshed Fabian Proft Mikhail Protopopov Valeria Rios Rodriguez Judith Rademacher Juliane Greese Dominik Deppe Felix Radny Katharina Ziegeler Kay Geert A Hermann Carsten Stelbrink |
| author_sort | Denis Poddubnyy |
| collection | DOAJ |
| description | Objective Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT.Methods This post hoc analysis included 163 subjects with low back pain. Eighty-nine patients had axSpA, and 74 patients had other conditions (mechanical, degenerative or non-specific low back pain). Final diagnoses were established by an experienced rheumatologist before the reading sessions. Nine blinded readers (divided into three groups with different levels of experience) scored the XR, CT and MRI of the sacroiliac joints for the presence versus absence of axSpA. Parameters for diagnostic performance were calculated using contingency tables. Differences in diagnostic performance between the reader groups were assessed using the McNemar test. Inter-rater reliability was assessed using Fleiss kappa.Results Diagnostic performance was highest for the most experienced reader group, except for XR. In the inexperienced and semi-experienced group, diagnostic performance was highest for CT&MRI (78.5% and 85.3%, respectively). In the experienced group, MRI showed the highest performance (85.9%). The greatest difference in diagnostic performance was found for MRI between the inexperienced and experienced group (76.1% vs 85.9%, p=0.001). Inter-rater agreement was best for CT in the experienced group with κ=0.87.Conclusion Differences exist in the learnability of the imaging modalities for axSpA diagnosis. MRI requires more experience, while CT is more suitable for inexperienced radiologists. However, diagnosis relies on both clinical and imaging information. |
| first_indexed | 2024-03-07T15:43:50Z |
| format | Article |
| id | doaj.art-ab35a037e4a54822bdf1809e480948a1 |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2024-04-24T13:15:15Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-ab35a037e4a54822bdf1809e480948a12024-04-04T19:20:09ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003944Learning imaging in axial spondyloarthritis: more than just a matter of experienceDenis Poddubnyy0Torsten Diekhoff1Sevtap Tugce Ulas2Robert Biesen3Hildrun Haibel4Iris Eshed5Fabian Proft6Mikhail Protopopov7Valeria Rios Rodriguez8Judith Rademacher9Juliane Greese10Dominik Deppe11Felix Radny12Katharina Ziegeler13Kay Geert A Hermann14Carsten Stelbrink15Department of Gastroenterology, Infectious Diseases and Rheumatology (including Clinical Nutrition), Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin, Berlin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Rheumatology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDiagnostic Imaging, Sheba Medical Center, Tel Hashomer, IsraelDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyObjective Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT.Methods This post hoc analysis included 163 subjects with low back pain. Eighty-nine patients had axSpA, and 74 patients had other conditions (mechanical, degenerative or non-specific low back pain). Final diagnoses were established by an experienced rheumatologist before the reading sessions. Nine blinded readers (divided into three groups with different levels of experience) scored the XR, CT and MRI of the sacroiliac joints for the presence versus absence of axSpA. Parameters for diagnostic performance were calculated using contingency tables. Differences in diagnostic performance between the reader groups were assessed using the McNemar test. Inter-rater reliability was assessed using Fleiss kappa.Results Diagnostic performance was highest for the most experienced reader group, except for XR. In the inexperienced and semi-experienced group, diagnostic performance was highest for CT&MRI (78.5% and 85.3%, respectively). In the experienced group, MRI showed the highest performance (85.9%). The greatest difference in diagnostic performance was found for MRI between the inexperienced and experienced group (76.1% vs 85.9%, p=0.001). Inter-rater agreement was best for CT in the experienced group with κ=0.87.Conclusion Differences exist in the learnability of the imaging modalities for axSpA diagnosis. MRI requires more experience, while CT is more suitable for inexperienced radiologists. However, diagnosis relies on both clinical and imaging information.https://rmdopen.bmj.com/content/10/1/e003944.full |
| spellingShingle | Denis Poddubnyy Torsten Diekhoff Sevtap Tugce Ulas Robert Biesen Hildrun Haibel Iris Eshed Fabian Proft Mikhail Protopopov Valeria Rios Rodriguez Judith Rademacher Juliane Greese Dominik Deppe Felix Radny Katharina Ziegeler Kay Geert A Hermann Carsten Stelbrink Learning imaging in axial spondyloarthritis: more than just a matter of experience RMD Open |
| title | Learning imaging in axial spondyloarthritis: more than just a matter of experience |
| title_full | Learning imaging in axial spondyloarthritis: more than just a matter of experience |
| title_fullStr | Learning imaging in axial spondyloarthritis: more than just a matter of experience |
| title_full_unstemmed | Learning imaging in axial spondyloarthritis: more than just a matter of experience |
| title_short | Learning imaging in axial spondyloarthritis: more than just a matter of experience |
| title_sort | learning imaging in axial spondyloarthritis more than just a matter of experience |
| url | https://rmdopen.bmj.com/content/10/1/e003944.full |
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