Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability
Abstract Background Type 1 Chiari malformation (CM-I) has been historically defined by cerebellar tonsillar position (TP) greater than 3–5 mm below the foramen magnum (FM). Often, the radiographic findings are highly variable, which may influence the clinical course and patient outcome. In this stud...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Fluids and Barriers of the CNS |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12987-018-0118-1 |
| _version_ | 1811269947031027712 |
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| author | Braden J. Lawrence Aintzane Urbizu Philip A. Allen Francis Loth R. Shane Tubbs Alexander C. Bunck Jan-Robert Kröger Brandon G. Rocque Casey Madura Jason A. Chen Mark G. Luciano Richard G. Ellenbogen John N. Oshinski Bermans J. Iskandar Bryn A. Martin |
| author_facet | Braden J. Lawrence Aintzane Urbizu Philip A. Allen Francis Loth R. Shane Tubbs Alexander C. Bunck Jan-Robert Kröger Brandon G. Rocque Casey Madura Jason A. Chen Mark G. Luciano Richard G. Ellenbogen John N. Oshinski Bermans J. Iskandar Bryn A. Martin |
| author_sort | Braden J. Lawrence |
| collection | DOAJ |
| description | Abstract Background Type 1 Chiari malformation (CM-I) has been historically defined by cerebellar tonsillar position (TP) greater than 3–5 mm below the foramen magnum (FM). Often, the radiographic findings are highly variable, which may influence the clinical course and patient outcome. In this study, we evaluate the inter-operator reliability (reproducibility) of MRI-based measurement of TP in CM-I patients and healthy controls. Methods Thirty-three T2-weighted MRI sets were obtained for 23 CM-I patients (11 symptomatic and 12 asymptomatic) and 10 healthy controls. TP inferior to the FM was measured in the mid-sagittal plane by seven expert operators with reference to McRae’s line. Overall agreement between the operators was quantified by intraclass correlation coefficient (ICC). Results The mean and standard deviation of cerebellar TP measurements for asymptomatic (CM-Ia) and symptomatic (CM-Is) patients in mid-sagittal plane was 6.38 ± 2.19 and 9.57 ± 2.63 mm, respectively. TP measurements for healthy controls was 0.48 ± 2.88 mm. The average range of TP measurements for all data sets analyzed was 7.7 mm. Overall operator agreement for TP measurements was relatively high with an ICC of 0.83. Conclusion The results demonstrated a large average range (7.7 mm) of measurements among the seven expert operators and support that, if economically feasible, two radiologists should make independent measurements before radiologic diagnosis of CM-I and surgery is contemplated. In the future, an objective diagnostic parameter for CM-I that utilizes automated algorithms and results in smaller inter-operator variation may improve patient selection. |
| first_indexed | 2024-04-12T21:52:17Z |
| format | Article |
| id | doaj.art-b60e95cb13414bcdaf2b5d9e3d3f1b5c |
| institution | Directory Open Access Journal |
| issn | 2045-8118 |
| language | English |
| last_indexed | 2024-04-12T21:52:17Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Fluids and Barriers of the CNS |
| spelling | doaj.art-b60e95cb13414bcdaf2b5d9e3d3f1b5c2022-12-22T03:15:27ZengBMCFluids and Barriers of the CNS2045-81182018-12-0115111010.1186/s12987-018-0118-1Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliabilityBraden J. Lawrence0Aintzane Urbizu1Philip A. Allen2Francis Loth3R. Shane Tubbs4Alexander C. Bunck5Jan-Robert Kröger6Brandon G. Rocque7Casey Madura8Jason A. Chen9Mark G. Luciano10Richard G. Ellenbogen11John N. Oshinski12Bermans J. Iskandar13Bryn A. Martin14Department of Biological Engineering, University of IdahoCenter for Human Disease Modeling, Duke University Medical CenterDepartment of Psychology, University of AkronDepartment of Mechanical Engineering, University of AkronSeattle Science FoundationDepartment of Radiology, University Hospital of CologneDepartment of Radiology, University Hospital of CologneDepartment of Neurosurgery, University of Alabama at BirminghamDepartment of Neurosurgery, Helen DeVos Children’s HospitalSemel Institute for Neuroscience and Human Behavior, University of CaliforniaDepartment of Neurosurgery, Johns Hopkins UniversityDepartment of Neurological Surgery, University of WashingtonDepartment of Radiology & Imaging Science and Biomedical Engineering, Emory UniversityDepartment of Neurological Surgery, University of WisconsinDepartment of Biological Engineering, University of IdahoAbstract Background Type 1 Chiari malformation (CM-I) has been historically defined by cerebellar tonsillar position (TP) greater than 3–5 mm below the foramen magnum (FM). Often, the radiographic findings are highly variable, which may influence the clinical course and patient outcome. In this study, we evaluate the inter-operator reliability (reproducibility) of MRI-based measurement of TP in CM-I patients and healthy controls. Methods Thirty-three T2-weighted MRI sets were obtained for 23 CM-I patients (11 symptomatic and 12 asymptomatic) and 10 healthy controls. TP inferior to the FM was measured in the mid-sagittal plane by seven expert operators with reference to McRae’s line. Overall agreement between the operators was quantified by intraclass correlation coefficient (ICC). Results The mean and standard deviation of cerebellar TP measurements for asymptomatic (CM-Ia) and symptomatic (CM-Is) patients in mid-sagittal plane was 6.38 ± 2.19 and 9.57 ± 2.63 mm, respectively. TP measurements for healthy controls was 0.48 ± 2.88 mm. The average range of TP measurements for all data sets analyzed was 7.7 mm. Overall operator agreement for TP measurements was relatively high with an ICC of 0.83. Conclusion The results demonstrated a large average range (7.7 mm) of measurements among the seven expert operators and support that, if economically feasible, two radiologists should make independent measurements before radiologic diagnosis of CM-I and surgery is contemplated. In the future, an objective diagnostic parameter for CM-I that utilizes automated algorithms and results in smaller inter-operator variation may improve patient selection.http://link.springer.com/article/10.1186/s12987-018-0118-1Cerebellar tonsilInter-operator reliabilityMorphometricMRISyringomyeliaType 1 Chiari malformation |
| spellingShingle | Braden J. Lawrence Aintzane Urbizu Philip A. Allen Francis Loth R. Shane Tubbs Alexander C. Bunck Jan-Robert Kröger Brandon G. Rocque Casey Madura Jason A. Chen Mark G. Luciano Richard G. Ellenbogen John N. Oshinski Bermans J. Iskandar Bryn A. Martin Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability Fluids and Barriers of the CNS Cerebellar tonsil Inter-operator reliability Morphometric MRI Syringomyelia Type 1 Chiari malformation |
| title | Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability |
| title_full | Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability |
| title_fullStr | Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability |
| title_full_unstemmed | Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability |
| title_short | Cerebellar tonsil ectopia measurement in type I Chiari malformation patients show poor inter-operator reliability |
| title_sort | cerebellar tonsil ectopia measurement in type i chiari malformation patients show poor inter operator reliability |
| topic | Cerebellar tonsil Inter-operator reliability Morphometric MRI Syringomyelia Type 1 Chiari malformation |
| url | http://link.springer.com/article/10.1186/s12987-018-0118-1 |
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