Learning imaging in axial spondyloarthritis: more than just a matter of experience.

Autor:	Radny F; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Ziegeler K; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany.; Department of Hematology, Oncology, Tumor Immunology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Eshed I; Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Greese J; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Deppe D; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Stelbrink C; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Biesen R; Department of Rheumatology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Haibel H; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany., Rios Rodriguez V; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany., Rademacher J; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany.; Berlin Institute of Health at Charité, Berlin, Germany., Protopopov M; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany., Proft F; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany., Hermann KGA; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany., Poddubnyy D; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany., Diekhoff T; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany.; Berlin Institute of Health at Charité, Berlin, Germany., Ulas ST; Department of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany sevtap-tugce.ulas@charite.de.; Berlin Institute of Health at Charité, Berlin, Germany.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2024 Mar 04; Vol. 10 (1). Date of Electronic Publication: 2024 Mar 04.
DOI:	10.1136/rmdopen-2023-003944
Abstrakt:	Objective: Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT. Methods: This post hoc analysis included 163 subjects with low back pain. Eighty-nine patients had axSpA, and 74 patients had other conditions (mechanical, degenerative or non-specific low back pain). Final diagnoses were established by an experienced rheumatologist before the reading sessions. Nine blinded readers (divided into three groups with different levels of experience) scored the XR, CT and MRI of the sacroiliac joints for the presence versus absence of axSpA. Parameters for diagnostic performance were calculated using contingency tables. Differences in diagnostic performance between the reader groups were assessed using the McNemar test. Inter-rater reliability was assessed using Fleiss kappa. Results: Diagnostic performance was highest for the most experienced reader group, except for XR. In the inexperienced and semi-experienced group, diagnostic performance was highest for CT&MRI (78.5% and 85.3%, respectively). In the experienced group, MRI showed the highest performance (85.9%). The greatest difference in diagnostic performance was found for MRI between the inexperienced and experienced group (76.1% vs 85.9%, p=0.001). Inter-rater agreement was best for CT in the experienced group with κ=0.87. Conclusion: Differences exist in the learnability of the imaging modalities for axSpA diagnosis. MRI requires more experience, while CT is more suitable for inexperienced radiologists. However, diagnosis relies on both clinical and imaging information. Competing Interests: Competing interests: KZ reports funding (research grant) from the Assessment of Spondyloarthritis international Society (ASAS) during the conduct of this study. IE reports personal fees from AbbVie, Elli Lili and Novartis. RB reports personal fees from AstraZeneca, Galapagos, GlaxoSmithKline, Medac and Novartis. HH reports grants from Sobi and personal fees from AbbVie, Novartis, Pfizer, Roche and UCB outside the submitted work. JR is participant in the BIH-Charité Clinician Scientist Programme funded by the Charité—Universitätsmedizin Berlin and the Berlin Institute of Health. FP reports grants and personal fees from Novartis, Lilly and UCB, as well as personal fees from AbbVie, Amgen, BMS, Hexal, Janssen, MSD, Pfizer and Roche. K-GAH reports personal fees from AbbVie, MSD, Pfizer and Novartis, he is also the co-founder of BerlinFlame. DP reports grants and personal fees from AbbVie, Eli Lilly, MSD, Novartis and Pfizer and personal fees from Bristol-Myers Squibb, Roche, UCB, Biocad, GlaxoSmithKline and Gilead outside the submitted work. TD reports personal fees from MSD, Novartis and Eli Lilly and reports funding from the Berlin Institute of Health (BIH) during the conduct of this study. STU reports funding from BIH during the conduct of this study (Junior Digital Clinician Scientist Program). All other authors report no funding. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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