Inter-modality assessment of medial temporal lobe atrophy in a non-demented population: application of a visual rating scale template across radiologists with varying clinical experience

• Published in: European radiology 2022-02, Vol.32 (2), p.1127-1134
• Main Authors: Håkansson, Claes, Tamaddon, Ashkan, Andersson, Henrik, Torisson, Gustav, Mårtensson, Gustav, Truong, My, Annertz, Mårten, Londos, Elisabet, Björkman-Burtscher, Isabella M., Hansson, Oskar, van Westen, Danielle
• Format: Article
• Language: English
• Subjects: Accuracy; Aged; agreement; Agreements; Alzheimer Disease - pathology; Atrophy; Atrophy - pathology; Basic Medicine; Cognitive ability; Cognitive dysfunction; Cognitive Dysfunction - pathology; computed; Computed tomography; Consensus; dementia; Diagnostic Radiology; Humans; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance Imaging; Medical and Health Sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Medicinska och farmaceutiska grundvetenskaper; Neuro; Neuroradiology; Neurosciences; Neurovetenskaper; Nuclear Medicine & Medical Imaging; Population; Radiologi och bildbehandling; Radiologists; Radiology; Radiology, Nuclear Medicine and Medical Imaging; Ratings; Ratings & rankings; reliability; Temporal lobe; Temporal Lobe - diagnostic imaging; Temporal Lobe - pathology; Tomography; Tomography, X-ray computed; Ultrasound; X-ray
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-021-08177-1

Objectives To assess inter-modality agreement and accuracy for medial temporal lobe atrophy (MTA) ratings across radiologists with varying clinical experience in a non-demented population. Methods Four raters (two junior radiologists and two senior neuroradiologists) rated MTA on CT and MRI scans using Scheltens’ MTA scale. Ratings were compared to a consensus rating by two experienced neuroradiologists for estimation of true positive and negative rates (TPR and TNR) and over- and underestimation of MTA. Inter-modality agreement expressed as Cohen’s κ (dichotomized data), Cohen’s κ w , and two-way mixed, single measures, consistency ICC (ordinal data) were determined. Adequate agreement was defined as κ/κ w ≥ 0.80 and ICC ≥ 0.80 (significance level at 95% CI ≥ 0.65). Results Forty-nine subjects (median age 72 years, 27% abnormal MTA) with cognitive impairment were included. Only junior radiologists achieved adequate agreement expressed as Cohen’s κ. All raters achieved adequate agreement expressed as Cohen’s κ w and ICC. True positive rates varied from 69 to 100% and TNR varied from 85 to 100%. No under- or overestimation of MTA was observed. Ratings did not differ between radiologists. Conclusion We conclude that radiologists with varying experience achieve adequate inter-modality agreement and similar accuracy when Scheltens’ MTA scale is used to rate MTA on a non-demented population. However, TPR varied between radiologists which could be attributed to rating style differences. Key Points • Radiologists with varying experience achieve adequate inter-modality agreement with similar accuracy when Scheltens’ MTA scale is used to rate MTA on a non-demented population . • Differences in rating styles might affect accuracy, this was most evident for senior neuroradiologists, and only junior radiologists achieved adequate agreement on dichotomized (abnormal/normal) ratings . • The use of an MTA scale template might compensate for varying clinical experience which could make it applicable for clinical use .