Interobserver agreement on the radiological criteria of the International Panel on the diagnosis of multiple sclerosis |
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Authors: | Tijmen Korteweg Bernard M J Uitdehaag Dirk L Knol Robin H M Smithuis Paul R Algra Cees de Vries Peter A Poppe Jan-Hein T M van Waesberghe Elisabeth Bergers Geert J Lycklama à Nijeholt Chris H Polman Frederik Barkhof |
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Institution: | (1) Department of Radiology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;(2) Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands;(3) Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands;(4) Department of Radiology, Rijnland Hospital, Leiderdorp, The Netherlands;(5) Department of Radiology, Medical Centre Alkmaar, Alkmaar, The Netherlands;(6) Department of Radiology, OLVG, Amsterdam, The Netherlands |
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Abstract: | We assessed the interobserver agreement on the radiological part of the International Panel (IP) criteria for the diagnosis
of multiple sclerosis (MS), comprising the assessment of dissemination in space (DIS) and time (DIT) based exclusively on
MRI. Four radiologists trained and four radiologists naive in the application of the IP criteria scored the fulfillment for
DIS (i.e., ≥3 periventricular, ≥1 infratentorial, ≥1 juxtacortical, ≥ 1 enhancing lesion or a total of ≥9 T2-weighted lesions)
and DIT (presence of new or enhancing lesions at follow-up) in baseline and two follow-up scans from 20 patients suspected
for having MS. The IP-trained radiologists agreed at least moderately on all assessments (κ>0.40), whereas the IP-naive radiologists
showed fair agreement (κ<0.40) on five of 16 assessments. In the final conclusion on DIS and DIT, the IP-trained radiologists
agreed substantially on both items (κ=0.62 and κ=0.60, respectively) compared with a fair agreement on DIS (κ=0.29) and moderate
agreement on DIT (κ=0.52) among the IP-naive radiologists. Given the poor interobserver agreement among IP-naive observers,
the new IP criteria for MS require additional training and should perhaps be simplified. |
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Keywords: | MRI Diagnosis Brain Multiple sclerosis |
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