Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke
Background: The evaluation of DWI/FLAIR mismatch in ischaemic stroke patients with unknown, time from onset can determine the treatment strategy. This approach is based on, visual assessment and may be subject to insufficient inter-rater agreement. Objective: To compare the inter-rater agreement of...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | European Journal of Radiology Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S235204772300014X |
| _version_ | 1797802198772482048 |
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| author | J. Civrny Z. Sedlackova T. Malenak P. Kucera D. Machal M. Kocher D. Sanak T. Furst M. Cerna |
| author_facet | J. Civrny Z. Sedlackova T. Malenak P. Kucera D. Machal M. Kocher D. Sanak T. Furst M. Cerna |
| author_sort | J. Civrny |
| collection | DOAJ |
| description | Background: The evaluation of DWI/FLAIR mismatch in ischaemic stroke patients with unknown, time from onset can determine the treatment strategy. This approach is based on, visual assessment and may be subject to insufficient inter-rater agreement. Objective: To compare the inter-rater agreement of visual evaluation of FLAIR MRI and proposed region of interest (ROI) semiquantitative method in large vessel occlusion (LVO) strokes. Methods: Five readers have analysed MRIs of 104 patients obtained within six hours of the onset of stroke symptoms resulting from LVO visually and semi-quantitatively. For the semiquantitative analysis, a ROI method was used to obtain relative signal intensity compared to the unaffected side. Cut-off values of 1.15 and 1.10 were tested. The analysis yielded FLAIR-positive (abnormal) and negative (normal) findings. Percentage agreement and Fleiss kappa coefficients were calculated. Results: The visual agreement of 5/5 readers and ≥ 4/5 readers occurred in 31% and 59% of cases respectively. Semi-quantitative evaluation using a cut-off value of 1.15 increased the agreements to 67% and 88% respectively. The agreement of visual evaluation was fair. The semi-quantitative method utilising the cut-off of 1.15 had moderate agreement although it increased the number of FLAIR-negative results compared to the visual evaluation. A low cut-off value of 1.10 didn’t improve the agreement significantly. Conclusion: The inter-rater agreement of visual evaluation of FLAIR in patients with short-duration large vessel occlusion stroke was fair. The high cut-off value of semiquantitative evaluation increased the agreement although it changed the proportion of FLAIR positive and negative results. |
| first_indexed | 2024-03-13T05:02:41Z |
| format | Article |
| id | doaj.art-cb50a41be87d4981ae54de3782da500a |
| institution | Directory Open Access Journal |
| issn | 2352-0477 |
| language | English |
| last_indexed | 2024-03-13T05:02:41Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Radiology Open |
| spelling | doaj.art-cb50a41be87d4981ae54de3782da500a2023-06-17T05:18:54ZengElsevierEuropean Journal of Radiology Open2352-04772023-01-0110100488Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic strokeJ. Civrny0Z. Sedlackova1T. Malenak2P. Kucera3D. Machal4M. Kocher5D. Sanak6T. Furst7M. Cerna8Department of Radiology, Palacky University and University Hospital, Olomouc, Czech Republic; Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic; Correspondence to: University Hospital Olomouc, Department of Radiology, Krizkovskeho 511/8 185/6, 779 00 Olomouc, Czech Republic.Department of Radiology, Palacky University and University Hospital, Olomouc, Czech Republic; Faculty of Health Sciences, Palacky University, Olomouc, Czech RepublicDepartment of Radiology, Palacky University and University Hospital, Olomouc, Czech RepublicDepartment of Radiology, Palacky University and University Hospital, Olomouc, Czech RepublicDepartment of Radiology, Palacky University and University Hospital, Olomouc, Czech RepublicDepartment of Radiology, Palacky University and University Hospital, Olomouc, Czech RepublicDepartment of Neurology, Palacky University and University Hospital, Olomouc, Czech RepublicDepartment of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University Olomouc, Czech RepublicDepartment of Radiology, Palacky University and University Hospital, Olomouc, Czech RepublicBackground: The evaluation of DWI/FLAIR mismatch in ischaemic stroke patients with unknown, time from onset can determine the treatment strategy. This approach is based on, visual assessment and may be subject to insufficient inter-rater agreement. Objective: To compare the inter-rater agreement of visual evaluation of FLAIR MRI and proposed region of interest (ROI) semiquantitative method in large vessel occlusion (LVO) strokes. Methods: Five readers have analysed MRIs of 104 patients obtained within six hours of the onset of stroke symptoms resulting from LVO visually and semi-quantitatively. For the semiquantitative analysis, a ROI method was used to obtain relative signal intensity compared to the unaffected side. Cut-off values of 1.15 and 1.10 were tested. The analysis yielded FLAIR-positive (abnormal) and negative (normal) findings. Percentage agreement and Fleiss kappa coefficients were calculated. Results: The visual agreement of 5/5 readers and ≥ 4/5 readers occurred in 31% and 59% of cases respectively. Semi-quantitative evaluation using a cut-off value of 1.15 increased the agreements to 67% and 88% respectively. The agreement of visual evaluation was fair. The semi-quantitative method utilising the cut-off of 1.15 had moderate agreement although it increased the number of FLAIR-negative results compared to the visual evaluation. A low cut-off value of 1.10 didn’t improve the agreement significantly. Conclusion: The inter-rater agreement of visual evaluation of FLAIR in patients with short-duration large vessel occlusion stroke was fair. The high cut-off value of semiquantitative evaluation increased the agreement although it changed the proportion of FLAIR positive and negative results.http://www.sciencedirect.com/science/article/pii/S235204772300014XMagnetic resonance imagingIschemic strokeMismatch |
| spellingShingle | J. Civrny Z. Sedlackova T. Malenak P. Kucera D. Machal M. Kocher D. Sanak T. Furst M. Cerna Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke European Journal of Radiology Open Magnetic resonance imaging Ischemic stroke Mismatch |
| title | Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke |
| title_full | Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke |
| title_fullStr | Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke |
| title_full_unstemmed | Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke |
| title_short | Comparison of semi-quantitative and visual assessment of early MRI signal evolution in acute ischaemic stroke |
| title_sort | comparison of semi quantitative and visual assessment of early mri signal evolution in acute ischaemic stroke |
| topic | Magnetic resonance imaging Ischemic stroke Mismatch |
| url | http://www.sciencedirect.com/science/article/pii/S235204772300014X |
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