Inter-rater Agreement in Three Perfusion-Computed Tomography Evaluation Methods before Endovascular Therapy for Acute Ischemic Stroke.

Détails

ID Serval
serval:BIB_8ADBF0649E36
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Inter-rater Agreement in Three Perfusion-Computed Tomography Evaluation Methods before Endovascular Therapy for Acute Ischemic Stroke.
Périodique
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
Auteur(s)
Khaw A.V., Angermaier A., Michel P., Kirsch M., Kessler C., Langner S.
ISSN
1532-8511 (Electronic)
ISSN-L
1052-3057
Statut éditorial
Publié
Date de publication
04/2016
Peer-reviewed
Oui
Volume
25
Numéro
4
Pages
960-968
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication types: Journal Article ; Multicenter Study

Résumé
There is ongoing debate on which method of perfusion computed tomography (PCT) evaluation in ischemic stroke is the most appropriate for improved selection of patients for endovascular treatment. We sought to test different assessment methods for inter-rater reliability.
Twenty-six patients were enrolled prospectively before endovascular therapy for acute anterior circulation ischemic stroke. Three raters experienced in stroke imaging and blinded to other imaging and clinical information independently analyzed 22 technically successful PCT scans according to 3 prespecified assessment methods applied to cerebral blood flow (CBF)/cerebral blood volume (CBV) and time-to-peak (TTP) maps: (1) visual mismatch estimate (VME), (2) Alberta Stroke Program Early CT Score perfusion method (ASPECTS-PCT), and (3) quantitative perfusion ratios (qPRs): RCBF, RCBV, RTTP. Inter-rater agreement was assessed with Cohen's kappa, intraclass correlation coefficients (ICC), Bland-Altman plots, and global and descriptive statistics.
Significant differences between raters were found with VME and ASPECTS-PCT (P < .001) but with qPRs only for CBV (P = .03). Inter-rater agreement for VME was at best moderate by kappa statistics (.51); moderate by ICC for all parametric maps of ASPECTS-PCT (.56-.62), strong for RTTP (.76), and excellent for RCBF (.92) and RCBV (.86). Pairwise comparisons revealed less scattering of individual values with qPRs and less deviation of mean differences from 0, suggesting minor systematic deviation by any 1 rater as compared with VME or ASPECTS-PCT.
PCT evaluation methods used before endovascular therapy for acute anterior circulation stroke are subject to substantial inter-rater disagreement. QPRs in PCT evaluation had better inter-rater reliability than the often used VME and ASPECTS-PCT assessment.

Mots-clé
Adult, Aged, Aged, 80 and over, Blood Volume/physiology, Brain Ischemia/complications, Cerebrovascular Circulation/physiology, Computed Tomography Angiography, Female, Humans, Male, Middle Aged, Perfusion, Reproducibility of Results, Stroke/diagnostic imaging, Stroke/etiology
Pubmed
Création de la notice
20/02/2016 16:44
Dernière modification de la notice
03/03/2018 19:10
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