Application of a computerized language lateralization index from FMRI by a group of clinical neuroradiologists
| Autor: | A. L. Tievsky, Stephen E. Jones, Micheal D. Phillips, Alison S. Smith, Doksu Moon, Shamseldeen Y. Mahmoud, Jorge Gonzalez-Martinez, Todd W. Stultz, Daniel Lockwood |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Context (language use) Audiology Sensitivity and Specificity Lateralization of brain function Functional Laterality Young Adult Neuroimaging Image Interpretation Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging Child Language lateralization Aged Language Cerebral Cortex Observer Variation Brain Diseases Brain Mapping Language Tests Functional business.industry Reproducibility of Results Middle Aged Magnetic Resonance Imaging body regions Female Neurology (clinical) Nerve Net business Social psychology Algorithms |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X |
| Popis: | BACKGROUND AND PURPOSE: Deriving accurate language lateralization from fMRI studies in the clinical context can be difficult, with 10%–20% incorrect conclusions. Most interpretations are qualitative, performed by neuroimaging experts. Quantitative lateralization has been widely described but with little implementation in the clinical setting and is disadvantaged by the use of arbitrary threshold techniques. We investigated the application and utility of a nonthreshold CLI, in a clinical setting, as applied by a group of practicing neuroradiologists. MATERIALS AND METHODS: Twenty-two patients with known language lateralization (11 left and 11 nonleft dominant) had their images reviewed by 8 neuroradiologists in 2 settings, all randomized, once by using a CLI and once without using a CLI. For each review, neuroradiologists recorded their impressions of lateralization for each language sequence, the overall lateralization conclusion, their impression of scan quality and noise, and the subjective confidence in their conclusion. RESULTS: The inter-rater κ; for lateralization was 0.64, which increased to 0.70 with the use of CLI. The group accuracy of overall lateralization was 78%, which increased to 81% with the use of a CLI. Using a CLI removed 2 instances of significant errors, with a neuroradiologist9s impression of left lateralization in a patient with known right lateralization. Using a CLI had no effect on examinations with conclusions formed with either high confidence or no confidence. CONCLUSIONS: Although the overall clinical benefit of a CLI is modest, the most significant impact is to reduce the most harmful misclassification errors, particularly in fMRI examinations that are suboptimal. |
| Databáze: | OpenAIRE |
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