Inter-observer agreement of vertebral fracture assessment with dual-energy x-ray absorptiometry equipment.

Autor: Mostert JM; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands., Romeijn SR; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands., Dibbets-Schneider P; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands., Rietbergen DDD; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands., Pereira Arias-Bouda LM; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.; Department of Radiology, Alrijne Hospital, Leiderdorp, Netherlands., Götz C; ImageBiopsy Lab, Vienna, Austria., DiFranco MD; ImageBiopsy Lab, Vienna, Austria., Dimai HP; Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria., Grootjans W; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands. w.grootjans@lumc.nl.
Jazyk: angličtina
Zdroj: Archives of osteoporosis [Arch Osteoporos] 2021 Dec 10; Vol. 17 (1), pp. 4. Date of Electronic Publication: 2021 Dec 10.
DOI: 10.1007/s11657-021-01046-w
Abstrakt: Purpose: To investigate the time and effort needed to perform vertebral morphometry, as well as inter-observer agreement for identification of vertebral fractures on vertebral fracture assessment (VFA) images.
Methods: Ninety-six images were retrospectively selected, and three radiographers independently performed semi-automatic 6-point morphometry. Fractures were identified and graded using the Genant classification. Time needed to annotate each image was recorded, and reader fatigue was assessed using a modified Simulator Sickness Questionnaire (SSQ). Inter-observer agreement was assessed per-patient and per-vertebra for detecting fractures of all grades (grades 1-3) and for grade 2 and 3 fractures using the kappa statistic. Variability in measured vertebral height was evaluated using the intraclass correlation coefficient (ICC).
Results: Per-patient agreement was 0.59 for grades 1-3 fracture detection, and 0.65 for grades 2-3 only. Agreement for per-vertebra fracture classification was 0.92. Vertebral height measurements had an ICC of 0.96. Time needed to annotate VFA images ranged between 91 and 540 s, with a mean annotation time of 259 s. Mean SSQ scores were significantly lower at the start of a reading session (1.29; 95% CI: 0.81-1.77) compared to the end of a session (3.25; 95% CI: 2.60-3.90; p < 0.001).
Conclusion: Agreement for detection of patients with vertebral fractures was only moderate, and vertebral morphometry requires substantial time investment. This indicates that there is a potential benefit for automating VFA, both in improving inter-observer agreement and in decreasing reading time and burden on readers.
(© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.)
Databáze: MEDLINE
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