Korosoglou Grigorios, Abanador-Kamper Nadine, Tesche Christian, Renker Matthias, André Florian, Weichsel Loris, Hell Michaela, Bönner Florian, Cramer Mareike, Kelle Sebastian, Schulz-Menger Jeanette, Fehske Wolfgang, Rolf Andreas, Frey Norbert, Thiele Holger, Baldus Stephan
Department of Cardiology, Vascular Medicine and Pneumology, GRN Hospital Weinheim, Roentgenstr. 1, 69469, Weinheim, Germany.
Cardiac Imaging Center Weinheim, Hector Foundations, Weinheim, Germany.
Clin Res Cardiol. 2025 May 8. doi: 10.1007/s00392-025-02661-0.
To compare the reproducibility in reporting of coronary computed tomography angiography (CCTA) or cardiovascular magnetic resonance imaging (CMR) by certified readers for CCTA and CMR by the German Society of Cardiology (DGK) versus that by non-certified readers.
The study included 40 randomly selected CCTA and vasodilator stress CMR patient datasets. For CCTA, the degree of lumen narrowing, plaque composition, and high-risk plaque features were assessed. For CMR, wall motion and perfusion abnormalities and late gadolinium enhancement (LGE) were rated. All measures were conducted by segments and for individual patients. Intraclass correlation coefficients (ICC) were calculated to assess agreement between non-certified (n = 4) vs. DGK-certified readers (n = 4).
ICC for assessment of luminal narrowing, plaque composition, and high-risk features were, respectively, 0.65 (95% confidence intervals [CI] 0.59-0.69), 0.64 (95%CI 0.45-0.80), and 0.45 (95%CI 0.22-0.66) for non-certified versus 0.78 (95%CI 0.74-0.81), 0.88 (95%CI 0.79-0.93), and 0.89 (95%CI 0.81-0.95) for DGK-certified readers (p < 0.001 for all). ICC for the assessment of wall motion, perfusion, and LGE were, respectively, 0.41 (95%CI 0.35-0.48), 0.27 (95%CI 0.18-0.38), and 0.48 (95%CI 0.41-0.54) for non-certified versus 0.71 (95%CI 0.67-0.75), 0.71 (95%CI 0.67-0.75) and 0.67 (95%CI 0.62-0.71) for DGK-certified readers (p < 0.001 for all). The agreement was excellent among DGK-certified readers for obstructive CAD (≥ 70% lumen narrowing) assessed by CCTA and high for abnormal perfusion and for LGE by CMR in a per-patient analysis (0.88; 95%CI 0.79-0.94 and 0.84; 95%CI 0.71-0.92), respectively.
Substantially better CCTA and CMR reporting was observed for DGK-certified cardiologists, who achieved high agreement for diagnosing the presence or absence of obstructive CAD by CCTA and abnormal perfusion by CMR. Since important clinical decisions may be based on these readings, our data support quality-controlled education programs for advanced cardiac imaging.
比较德国心脏病学会（DGK）认证的冠状动脉计算机断层扫描血管造影（CCTA）和心血管磁共振成像（CMR）阅片者与非认证阅片者在报告CCTA或CMR时的可重复性。
该研究纳入了40个随机选择的CCTA和血管扩张剂负荷CMR患者数据集。对于CCTA，评估管腔狭窄程度、斑块成分和高危斑块特征。对于CMR，对室壁运动、灌注异常和延迟钆增强（LGE）进行评分。所有测量均按节段进行，并针对个体患者。计算组内相关系数（ICC）以评估非认证阅片者（n = 4）与DGK认证阅片者（n = 4）之间的一致性。
非认证阅片者评估管腔狭窄、斑块成分和高危特征的ICC分别为0.65（95%置信区间[CI] 0.59 - 0.69）、0.64（95%CI 0.45 - 0.80）和0.45（95%CI 0.22 - 0.66），而DGK认证阅片者分别为0.78（95%CI 0.74 - 0.81）、0.88（95%CI 0.79 - 0.93）和0.89（95%CI 0.81 - 0.95）（所有p < 0.001）。非认证阅片者评估室壁运动、灌注和LGE的ICC分别为0.41（95%CI 0.35 - 0.48）、0.27（95%CI 0.18 - 0.38）和0.48（95%CI 0.41 - 0.54），而DGK认证阅片者分别为0.71（95%CI 0.67 - 0.75）、0.71（95%CI 0.67 - 0.75）和0.67（95%CI 0.62 - 0.71）（所有p < 0.001）。在按患者分析中，DGK认证阅片者对CCTA评估的阻塞性CAD（管腔狭窄≥70%）、CMR评估的异常灌注和LGE的一致性分别为优秀（0.88；95%CI 0.79 - 0.94）和高度一致（0.84；95%CI 0.71 - 0.92）。
观察到DGK认证的心脏病专家对CCTA和CMR的报告质量明显更好，他们在通过CCTA诊断阻塞性CAD的存在与否以及通过CMR诊断异常灌注方面达成了高度一致。由于重要的临床决策可能基于这些读数，我们的数据支持针对高级心脏成像的质量控制教育计划。
