Journal article
Multirater agreement for grading the femoral and tibial cartilage surface lesions at CT arthrography and analysis of causes of disagreement.
- Omoumi P Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: patrick.omoumi@chuv.ch.
- Michoux N Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium.
- Larbi A Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium.
- Lacoste L Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium.
- Lecouvet FE Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium.
- Perlepe V Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium.
- Vande Berg BC Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Hippocrate Avenue 10/2942, B-1200 Brussels, Belgium.
- 2017-02-13
Published in:
- European journal of radiology. - 2017
Arthrography
Cartilage
Computed tomography
Grading system
Osteoarthritis
Thickness
Aged
Aged, 80 and over
Arthrography
Cartilage, Articular
Clinical Competence
Contrast Media
Female
Femur
Humans
Iothalamate Meglumine
Iothalamic Acid
Knee Joint
Male
Middle Aged
Multidetector Computed Tomography
Observer Variation
Osteoarthritis
Radiographic Image Enhancement
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Tibia
English
OBJECTIVE
To assess the multirater agreement of the modified Outerbridge system for the grading of predefined areas of femorotibial cartilage at CT arthrography with multiple readers, with varying experience.
DESIGN
Five readers with varying experience (two junior radiologists, three musculoskeletal radiologists including two experts in cartilage imaging) separately analyzed 962 cartilage sectors from pre-divided knee CT arthrograms with femorotibial osteoarthritis (Kellgren/Lawrence=3). Each cartilage area was graded twice by each reader, at a three-month interval, according to the modified 5-grade Outerbridge system. Interobserver and intraobserver agreement were assessed. After the second reading, 121 areas exhibiting the highest interobserver disagreement were reviewed in consensus to determine the sources of disagreement.
RESULTS
The global interobserver agreement was fair (k=0.35), and increased with the grade (from k=0.14 to k=0.76 from grade 0-4). The intraobserver agreement varied with the readers' experience from moderate (k=0.59) to almost perfect (k=0.92). The majority of cases of disagreement (44%) was due to difficulties in assessing the normal variations of cartilage thickness, including diffuse cartilage thinning (23%) and normal variants of cartilage thickness (22%). 32% of cases of disagreement were due to retrospectively avoidable interpretation errors.
CONCLUSIONS
The multirater agreement of the modified Outerbridge system is only fair when readers of different level of experience are taken into account, and interobserver agreement increases with readers' experience. However, interobserver agreement is substantial for grade 4 lesions. We report normal variations of cartilage thickness that may improve observer agreement in reporting cartilage lesions.
To assess the multirater agreement of the modified Outerbridge system for the grading of predefined areas of femorotibial cartilage at CT arthrography with multiple readers, with varying experience.
DESIGN
Five readers with varying experience (two junior radiologists, three musculoskeletal radiologists including two experts in cartilage imaging) separately analyzed 962 cartilage sectors from pre-divided knee CT arthrograms with femorotibial osteoarthritis (Kellgren/Lawrence=3). Each cartilage area was graded twice by each reader, at a three-month interval, according to the modified 5-grade Outerbridge system. Interobserver and intraobserver agreement were assessed. After the second reading, 121 areas exhibiting the highest interobserver disagreement were reviewed in consensus to determine the sources of disagreement.
RESULTS
The global interobserver agreement was fair (k=0.35), and increased with the grade (from k=0.14 to k=0.76 from grade 0-4). The intraobserver agreement varied with the readers' experience from moderate (k=0.59) to almost perfect (k=0.92). The majority of cases of disagreement (44%) was due to difficulties in assessing the normal variations of cartilage thickness, including diffuse cartilage thinning (23%) and normal variants of cartilage thickness (22%). 32% of cases of disagreement were due to retrospectively avoidable interpretation errors.
CONCLUSIONS
The multirater agreement of the modified Outerbridge system is only fair when readers of different level of experience are taken into account, and interobserver agreement increases with readers' experience. However, interobserver agreement is substantial for grade 4 lesions. We report normal variations of cartilage thickness that may improve observer agreement in reporting cartilage lesions.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ejrad.2016.12.026
- PMID 28189216
- Persistent URL
- https://roar.hep-bejune.ch/global/documents/266471
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