Preview

Radiology - Practice

Advanced search

Interexpert Agreement Between Emergency Neuroradiologists with Different Levels of Experience in the Rating of ASPECTS

https://doi.org/10.52560/2713-0118-2022-5-10-25

Abstract

Fifteen radiologists independently evaluated fifty non-contrast brain computed tomography of patients with middle cerebral artery (MCA) stroke. Within-group agreement was either negligible or moderate, and the best inter-expert agreement was observed between neuroradiologists with 1 to 3 years of experience. Our study allows us to conclude that ASPECTS is not an ideal tool for standardizing the diagnosis of MCA stroke, therefore, it is necessary to develop new models of standardization systems, as well as the use of hydride diagnostics, including automatic analysis.

About the Authors

P. L. Andropova
Institute of the Human Brain of the Russian Academy of Sciences
Russian Federation

Andropova Polina Leonidovna, post-graduate student

9, ul. Academician Pavlova, St. Petersburg, 197376



P. V. Gavrilov
Saint-Petersburg State Research Institute of Phthisiopulmonology
Russian Federation

Gavrilov Pavel Vladimirovich, Ph. D. Med, leading Researcher, Head of the Department of Radiology

2-4, Ligovsky prospect, 191036, St. Petersburg, 191036



I. P. Kazantseva
St. Petersburg State Budgetary Institution of Healthcare "Hospital for the war veterans"
Russian Federation

Kazantseva Inga Pavlovna, radiologist of the CT department

21, k. 2, ul. Narodnaya, St. Petersburg, 193079



N. I. Kochanova
St. Petersburg State Budgetary Institution of Healthcare "Hospital for the war veterans"
Russian Federation

Kochanova Natalia Igorevna, radiologist of the CT department

21, k. 2, ul. Narodnaya, St. Petersburg, 193079



A. N. Narkevich
Krasnoyarsk State Medical University named after Prof. V. F. Voino-Yasenetsky
Russian Federation

Narkevich Artem Nikolaevich, Doctor of Medical Sciences, Associate Professor, Dean of the Faculty of Medicine, Head of the Laboratory of Medical Cybernetics and Management in Healthcare, Head of the Department of Medical Cybernetics and Informatics

1, ul. Partizan Zheleznyak, 660022, Krasnoyarsk Territory, Krasnoyarsk, 660022



T. N. Trofimova
Institute of the Human Brain of the Russian Academy of Sciences
Russian Federation

Trofimova Tat'yana Nikolaevna, Corresponding Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Chief Freelance Specialist in Radiology and Instrumental Diagnostics

9, ul. Academician Pavlova, St. Petersburg, 197376



References

1. Barber P. A., Demchuk A. M., Zhang J., Buchan A. M. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000 May 13;355(9216):1670–4. DOI: 10.1016/s0140-6736(00)02237-6. Erratum in: Lancet 2000 Jun 17;355(9221):2170. PMID: 10905241.

2. Brinjikji W., Abbasi M., Arnold C., Benson J. C. et al. Е-ASPECTS software improves interobserver agreement and accuracy of interpretation of aspects score. Interv Neuroradiol. 2021 Dec;27(6):781–787. DOI: 10.1177/15910199211011861. Epub 2021 Apr 14. PMID: 33853441; PMCID: PMC8673896.

3. Coutts S. B., Demchuk A. M., Barber P. A., Hu W. Y. et al. Interobserver variation of ASPECTS in real time. Stroke. 2004 May;35(5):e103–5. DOI: 10.1161/01.STR.0000127082.19473.45. Epub 2004 Apr 8. PMID: 15073381.

4. Demchuk A. M., Hill M. D., Barber P. A., Silver B. et al. Importance of early ischemic computed tomography changes using ASPECTS in NINDS rtPA Stroke Study. Stroke. 2005 Oct;36(10):2110–5. DOI: 10.1161/01.STR.0000181116.15426.58. Epub 2005 Sep 15. PMID: 16166579.

5. Dzialowski I., Hill M. D., Coutts S. B., Demchuk A. M. et al. Extent of early ischemic changes on computed tomography (CT) before thrombolysis: prognostic value of the Alberta Stroke Program Early CT Score in ECASS II. Stroke. 2006 Apr;37(4):973–8. DOI: 10.1161/01.STR.0000206215.62441.56. Epub 2006 Feb 23. PMID: 16497977.

6. Farzin B., Fahed R., Guilbert F., Poppe A. Y. et al. Early CT changes in patients admitted for thrombectomy: Intrarater and interrater agreement. Neurology. 2016 Jul 19;87(3):249–56. DOI: 10.1212/WNL.0000000000002860. Epub 2016 Jun 17. PMID: 27316243; PMCID: PMC4955274.

7. Feng G. C. Mistakes and how to avoid mistakes in using intercoder reliability indices. Methodology. 2015;11:13–22. DOI: 10.1027/1614-2241/a000086

8. Finlayson O., John V., Yeung R., Dowlatshahi D. et al. Interobserver agreement of ASPECT score distribution for noncontrast CT, CT angiography, and CT perfusion in acute stroke. Stroke. 2013 Jan;44(1):234–6. DOI: 10.1161/STROKEAHA.112.665208. Epub 2012 Oct 25. PMID: 23103490.

9. Goyal M., Menon B. K., Coutts S. B., Hill M. D. et al. Effect of baseline CT scan appearance and time to recanalization on clinical outcomes in endovascular thrombectomy of acute ischemic strokes. Stroke. 2011 Jan;42(1):93–7. DOI: 10.1161/STROKEAHA.110.594481. Epub 2010 Nov 18. PMID: 21088240.

10. Gupta A. C., Schaefer P. W., Chaudhry Z. A., Leslie-Mazwi T. M. et al. Interobserver reliability of baseline noncontrast CT Alberta Stroke Program Early CT Score for intra-arterial stroke treatment selection. AJNR Am. J. Neuroradiol. 2012 Jun;33(6):1046-9. DOI: 10.3174/ajnr.A2942. Epub 2012 Feb 9. PMID: 22322602; PMCID: PMC8013224.

11. Herweh C., Ringleb P. A., Rauch G., Gerry S. et al. Performance of e-ASPECTS software in comparison to that of stroke physicians on assessing CT scans of acute ischemic stroke patients. Int J. Stroke. 2016 Jun;11(4):438–45. DOI: 10.1177/1747493016632244. Epub 2016 Feb 15. PMID: 26880058.

12. Hill M. D., Buchan A. M. Canadian Alteplase for Stroke Effectiveness Study (CASES) Investigators. Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study. CMAJ. 2005 May 10;172(10):1307–12. DOI: 10.1503/cmaj.1041561. PMID: 15883405; PMCID: PMC557101.

13. Hill M. D., Demchuk A. M., Tomsick T. A., Palesch Y. Y. et al. Using the baseline CT scan to select acute stroke patients for IV-IA therapy. AJNR Am. J. Neuroradiol. 2006 Sep;27(8):1612–6. PMID: 16971597; PMCID: PMC8139809.

14. Huo X., Raynald J. H., Yin Y. et al. Performance of automated CT ASPECTS in comparison to physicians at different levels on evaluating acute ischemic stroke at a single institution in China. Chin Neurosurg. J. 2021 Oct 1;7(1):40. DOI: 10.1186/s41016-021-00257-x. PMID: 34593050; PMCID: PMC8485462.

15. Kobkitsuksakul C., Tritanon O., Suraratdecha V. Interobserver agreement between senior radiology resident, neuroradiology fellow, and experienced neuroradiologist in the rating of Alberta Stroke Program Early Computed Tomography Score (ASPECTS). Diagn. Interv. Radiol. 2018 Mar-Apr;24(2):104–107. DOI: 10.5152/dir.2018.17336. PMID: 29467112; PMCID: PMC5873500.

16. MacCallum C., Churilov L., Mitchell P., Dowling R. et al. Low Alberta Stroke Program Early CT score (ASPECTS) associated with malignant middle cerebral artery infarction. Cerebrovasc. Dis. 2014;38(1):39–45. DOI: 10.1159/000363619. Epub 2014 Sep 16. PMID:25228461.

17. Modi J., Bai H. D., Menon B. K., Goyal M. Enhancing acute ischemic stroke interpretation with online aspects training. Can. J. Neurol. Sci. 2012 Jan;39(1): 112–4. DOI: 10.1017/s0317167100012841. PMID: 22384508.

18. Puetz V., Dzialowski I., Hill M. D., Demchuk A. M. The Alberta Stroke Program Early CT Score in clinical practice: what have we learned? Int J. Stroke. 2009 Oct;4(5):354–64. DOI: 10.1111/j.1747-4949.2009.00337.x. PMID: 19765124.

19. Saver J. L., Goyal M., Bonafe A., Diener H.-C. et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N. Engl. J. Med. 2015 Jun 11;372(24): 2285–95. DOI: 10.1056/NEJMoa1415061. Epub 2015 Apr 17. PMID: 25882376.

20. Turc G., Bhogal P., Fischer U., Khatri P. et al. European Stroke Organisation (ESO) — European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischemic Stroke. J. Neurointerv. Surg. 2019 Feb 26:neurintsurg-2018-014569. DOI: 10.1136/neurintsurg-2018-014569. Epub ahead of print. PMID: 30808653.


Supplementary files

Review

For citations:


Andropova P.L., Gavrilov P.V., Kazantseva I.P., Kochanova N.I., Narkevich A.N., Trofimova T.N. Interexpert Agreement Between Emergency Neuroradiologists with Different Levels of Experience in the Rating of ASPECTS. Radiology - Practice. 2022;(5):10-25. (In Russ.) https://doi.org/10.52560/2713-0118-2022-5-10-25

Views: 586


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2713-0118 (Online)