Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
J Digit Imaging. 2012 Apr;25(2):250-7. doi: 10.1007/s10278-011-9413-y.
The purpose of this study was to evaluate the influence of advanced software assistance on the assessment of carotid artery stenosis; particularly, the inter-observer variability of readers with different level of experience is to be investigated. Forty patients with suspected carotid artery stenosis received head and neck dual-energy CT angiography as part of their pre-interventional workup. Four blinded readers with different levels of experience performed standard imaging interpretation. At least 1 day later, they performed quantification using an advanced vessel analysis software including automatic dual-energy bone and hard plaque removal, automatic and semiautomatic vessel segmentation, as well as creation of curved planar reformation. Results were evaluated for the reproducibility of stenosis quantification of different readers by calculating the kappa and correlation values. Consensus reading of the two most experienced readers was used as the standard of reference. For standard imaging interpretation, experienced readers reached very good (k = 0.85) and good (k = 0.78) inter-observer variability. Inexperienced readers achieved moderate (k = 0.6) and fair (k = 0.24) results. Sensitivity values 80%, 91%, 83%, 77% and specificity values 100%, 84%, 82%, 53% were achieved for significant area stenosis >70%. For grading using advanced vessel analysis software, all readers achieved good inter-observer variability (k = 0.77, 0.72, 0.71, and 0.77). Specificity values of 97%, 95%, 95%, 93% and sensitivity values of 84%, 78%, 86%, 92% were achieved. In conclusion, when supported by advanced vessel analysis software, experienced readers are able to achieve good reproducibility. Even inexperienced readers are able to achieve good results in the assessment of carotid artery stenosis when using advanced vessel analysis software.
本研究旨在评估高级软件辅助对颈动脉狭窄评估的影响；特别是，要研究不同经验水平的读者之间的观察者间变异性。40 名疑似颈动脉狭窄的患者接受了头颈部双能 CT 血管造影术，作为其术前检查的一部分。四位具有不同经验水平的盲法读者进行了标准的影像学解读。至少 1 天后，他们使用先进的血管分析软件进行了定量分析，该软件包括自动双能骨和硬斑块去除、自动和半自动血管分割以及曲面重建。通过计算κ值和相关系数来评估不同读者狭窄定量评估的可重复性。使用两位最有经验的读者的共识阅读作为参考标准。对于标准影像学解读，有经验的读者达到了非常好（κ=0.85）和良好（κ=0.78）的观察者间变异性。无经验的读者达到了中度（κ=0.6）和公平（κ=0.24）的结果。对于>70%的显著面积狭窄，灵敏度值为 80%、91%、83%、77%，特异性值为 100%、84%、82%、53%。对于使用先进的血管分析软件进行分级，所有读者均达到了良好的观察者间变异性（κ=0.77、0.72、0.71 和 0.77）。特异性值为 97%、95%、95%、93%，灵敏度值为 84%、78%、86%、92%。总之，在先进的血管分析软件的支持下，有经验的读者能够实现良好的可重复性。即使使用先进的血管分析软件，经验不足的读者也能够在评估颈动脉狭窄方面取得良好的结果。
