Cardiac valve calcifications on low-dose unenhanced ungated chest computed tomography: inter-observer and inter-examination reliability,agreement and variability |
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| Authors: | Robbert W van Hamersvelt Martin J Willemink Richard A P Takx Anouk L M Eikendal Ricardo P J Budde Tim Leiner Christian P Mol Ivana Isgum Pim A de Jong |
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| Institution: | 1. Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, E01.132, 3508 GA, Utrecht, The Netherlands
2. Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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| Abstract: | Objectives To determine inter-observer and inter-examination variability for aortic valve calcification (AVC) and mitral valve and annulus calcification (MC) in low-dose unenhanced ungated lung cancer screening chest computed tomography (CT). Methods We included 578 lung cancer screening trial participants who were examined by CT twice within 3 months to follow indeterminate pulmonary nodules. On these CTs, AVC and MC were measured in cubic millimetres. One hundred CTs were examined by five observers to determine the inter-observer variability. Reliability was assessed by kappa statistics (κ) and intra-class correlation coefficients (ICCs). Variability was expressed as the mean difference ± standard deviation (SD). Results Inter-examination reliability was excellent for AVC (κ?=?0.94, ICC?=?0.96) and MC (κ?=?0.95, ICC?=?0.90). Inter-examination variability was 12.7?±?118.2 mm3 for AVC and 31.5?±?219.2 mm3 for MC. Inter-observer reliability ranged from κ?=?0.68 to κ?=?0.92 for AVC and from κ?=?0.20 to κ?=?0.66 for MC. Inter-observer ICC was 0.94 for AVC and ranged from 0.56 to 0.97 for MC. Inter-observer variability ranged from -30.5?±?252.0 mm3 to 84.0?±?240.5 mm3 for AVC and from -95.2?±?210.0 mm3 to 303.7?±?501.6 mm3 for MC. Conclusions AVC can be quantified with excellent reliability on ungated unenhanced low-dose chest CT, but manual detection of MC can be subject to substantial inter-observer variability. Lung cancer screening CT may be used for detection and quantification of cardiac valve calcifications. Key points ? Low-dose unenhanced ungated chest computed tomography can detect cardiac valve calcifications. ? However, calcified cardiac valves are not reported by most radiologists. ? Inter-observer and inter-examination variability of aortic valve calcifications is sufficient for longitudinal studies. ? Volumetric measurement variability of mitral valve and annulus calcifications is substantial. |
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