Clinical uncertainty in large vessel occlusion ischemic stroke: does automated perfusion imaging make a difference? An intra-rater and inter-rater agreement study

被引：0

作者：

Diestro, Jose Danilo Bengzon ^{[1
,2
,3
,4
]}

Fahed, Robert ^{[5
]}

Omar, Abdelsimar Tan ^{[6
]}

Hawkes, Christine ^{[7
]}

Hendriks, Eef J. ^{[8
]}

Enriquez, Clare ^{[7
]}

Eesa, Muneer ^{[9
]}

Stotts, Grant ^{[5
]}

Lee, Hubert ^{[10
]}

Nagendra, Shashank ^{[11
]}

Poppe, Alexandre ^{[12
]}

Ducroux, Celina ^{[5
]}

Lim, Timothy ^{[13
]}

Narvacan, Karl ^{[14
]}

Rizzuto, Michael ^{[15
]}

Alfalahi, Afra ^{[4
]}

Nishi, Hidehisa ^{[4
,16
]}

Sarma, Pragyan ^{[4
]}

Itsekson Hayosh, Ze'ev ^{[4
,8
]}

Ignacio, Katrina ^{[11
]}

Boisseau, William ^{[17
]}

Pimenta Ribeiro Pontes Almeida, Eduardo ^{[18
]}

Benomar, Anass ^{[19
]}

Almekhlafi, Mohammed A. ^{[20
,21
,22
,23
]}

Milot, Genvieve ^{[24
]}

Deshmukh, Aviraj ^{[25
]}

Kishore, Kislay ^{[6
]}

Tampieri, Donatella ^{[26
]}

Wang, Jeffrey ^{[2
]}

Srivastava, Abhilekh ^{[27
]}

Roy, Daniel ^{[28
]}

Carpani, Federico ^{[29
]}

Kashani, Nima ^{[30
]}

Candale-Radu, Claudia ^{[31
]}

Singh, Nishita ^{[31
]}

Bres Bullrich, Maria ^{[32
]}

Sarmiento, Robert ^{[33
]}

Muir, Ryan T. ^{[11
]}

Parra-Farinas, Carmen ^{[34
,35
]}

Reiter, Stephanie ^{[7
]}

Deschaintre, Yan ^{[12
]}

Singh, Ravinder-Jeet ^{[25
]}

Bodani, Vivek ^{[8
]}

Katsanos, Aristeidis ^{[27
]}

Agid, Ronit ^{[8
]}

Zafar, Atif ^{[2
]}

Pereira, Vitor M. ^{[3
,4
,36
]}

Spears, Julian ^{[36
]}

Marotta, Thomas R. ^{[3
,4
]}

Djiadeu, Pascal ^{[1
,37
]}

机构：

[1] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[2] Univ Toronto, St Michaels Hosp, Dept Med, Div Neurol,Unity Hlth Toronto, Toronto, ON, Canada

[3] Unity Hlth Toronto, St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

[4] Univ Toronto, Unity Hlth Toronto, St Michaels Hosp, Div Diagnost & Therapeut Neuroradiol,Dept Med Ima, Toronto, ON, Canada

[5] Univ Ottawa, Ottawa Hosp, Dept Med, Div Neurol,Res Inst, Ottawa, ON, Canada

[6] McMaster Univ, Dept Surg, Div Neurosurg, Hamilton, ON, Canada

[7] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med, Div Neurol, Toronto, ON, Canada

[8] Univ Toronto, Univ Hlth Network, Toronto Western Hosp, Joint Dept Med Imaging JDMI,Div Intervent Neurora, Toronto, ON, Canada

[9] Univ Calgary, Dept Radiol, Calgary, AB, Canada

[10] Trillium Hlth Partners, Div Neurointervent Neuroradiol, Div Neurosurg, Mississauga, ON, Canada

[11] Univ Calgary, Cumming Sch Med, Dept Clin Neurosci, Calgary, AB, Canada

[12] Univ Montreal, Fac Med, Dept Neurosci, Montreal, PQ, Canada

[13] Univ Toronto, Unity Hlth, Dept Med Imaging, Div Diagnost Neuroradiol,St Michaels Hosp, Toronto, ON, Canada

[14] Univ Toronto, St Michaels Hosp, Unity Hlth Toronto, Dept Med Imaging, Toronto, ON, Canada

[15] Univ British Columbia, Vancouver Gen Hosp, Dept Surg, Div Neurosurg, Vancouver, BC, Canada

[16] Koseikai Takeda Hosp, Dept Neurosurg, Kyoto, Japan

[17] Fdn Rothschild Hosp, Dept Intervent Neuroradiol, Paris, France

[18] Univ Hlth Network, Toronto Gen Hosp, Toronto, ON, Canada

[19] Ctr Hosp Univ Montreal, Dept Radiol, Montreal, PQ, Canada

[20] Univ Calgary, Hotchkiss Brain Inst, Dept Clin Neurosci, Calgary, AB, Canada

[21] Univ Calgary, Hotchkiss Brain Inst, Dept Radiol, Calgary, AB, Canada

[22] Univ Calgary, Hotchkiss Brain Inst, Dept Community Hlth Sci, Calgary, AB, Canada

[23] Univ Calgary, OBrien Inst Publ Hlth, Cumming Sch Med, Calgary, AB, Canada

[24] Univ Laval, Ctr Hosp Quebec, Dept Surg Neurosurg, Quebec City, PQ, Canada

[25] Northern Ontario Sch Med, Div Clin Sci, Hlth Sci North, Sudbury, ON, Canada

[26] Queens Univ, Kingston Hlth Sci Ctr, Dept Radiol, Kingston, ON, Canada

[27] McMaster Univ, Hamilton Gen Hosp, Dept Med, Div Neurol, Hamilton, ON, Canada

[28] Univ Montreal, Dept Radiol Radiooncol & Med Nucl, Montreal, PQ, Canada

[29] Univ Toronto, Univ Hlth Network, Toronto Western Hosp, Div Neurol,Dept Med, Toronto, ON, Canada

[30] Univ Saskatchewan, Royal Univ Hosp, Dept Med Imaging, Saskatoon, SK, Canada

[31] Univ Manitoba, Hlth Sci Ctr, Dept Internal Med, Div Neurol, Winnipeg, MB, Canada

[32] Western Univ, Schulich Sch Med & Dent, Dept Clin Neurol Sci, London, ON, Canada

[33] Univ British Columbia, Vancouver Gen Hosp, Dept Med, Div Neurol, Vancouver, BC V5Z 1M9, Canada

[34] Univ Toronto, Hosp Sick Children, Div Neuroradiol, Dept Diagnost & Intervent Radiol, Toronto, ON, Canada

[35] Univ Toronto, Hosp Sick Children, Dept Diagnost & Intervent Radiol, Div Neurointervent, Toronto, ON, Canada

[36] Univ Toronto, St Michaels Hosp, Unity Hlth Toronto, Div Neurosurg,Dept Surg, Toronto, ON, Canada

[37] McMaster Univ, Dept Global Hlth, Hamilton, ON, Canada

[38] McMaster Univ, Dept Surg, Hamilton, ON, Canada

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2024年

关键词：

Stroke; Thrombectomy; ENDOVASCULAR TREATMENT; LOW KAPPA; CT; THROMBECTOMY; RELIABILITY; GUIDELINES; SCORE;

D O I：

10.1136/jnis-2023-021429

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Background Limited research exists regarding the impact of neuroimaging on endovascular thrombectomy (EVT) decisions for late-window cases of large vessel occlusion (LVO) stroke.Objective T0 assess whether perfusion CT imaging: (1) alters the proportion of recommendations for EVT, and (2) enhances the reliability of EVT decision-making compared with non-contrast CT and CT angiography.Methods We conducted a survey using 30 patients drawn from an institutional database of 3144 acute stroke cases. These were presented to 29 Canadian physicians with and without perfusion imaging. We used non-overlapping 95% confidence intervals and difference in agreement classification as criteria to suggest a difference between the Gwet AC1 statistics (kappa G).Results The percentage of EVT recommendations differed by 1.1% with or without perfusion imaging. Individual decisions changed in 21.4% of cases (11.3% against EVT and 10.1% in favor). Inter-rater agreement (kappa G) among the 29 raters was similar between non-perfusion and perfusion CT neuroimaging (kappa G=0.487; 95% CI 0.327 to 0.647 and kappa G=0.552; 95% CI 0.430 to 0.675). The 95% CIs overlapped with moderate agreement in both. Intra-rater agreement exhibited overlapping 95% CIs for all 28 raters. kappa G was either substantial or excellent (0.81-1) for 71.4% (20/28) of raters in both groups.Conclusions Despite the minimal difference in overall EVT recommendations with either neuroimaging protocol one in five decisions changed with perfusion imaging. Regarding agreement we found that the use of automated CT perfusion images does not significantly impact the reliability of EVT decisions for patients with late-window LVO.

引用

页码：192 / 199

页数：8

共 9 条

[1] Clinical Uncertainty in Large Vessel Occlusion ischemic stroke (CULVO): Does automated perfusion scanning make a difference? Protocol of an intrarater and interrater agreement study
Diestro, Jose Danilo Bengzon
Fahed, Robert
Benomar, Anass
Omar II, Abdelsimar T.
Pereira, Vitor Mendes
Spears, Julian
Marotta, Thomas R.
Djiadeu, Pascal
Sharma, Sunjay
Farrokhyar, Forough
PLOS ONE, 2024, 19 (01):
[2] Smile Aesthetic Evaluation on Videographs: An Intra-Rater and Inter-Rater Agreement Study
Faure-Brac, Mathias
Antezack, Angeline
Melloul, Sebastien
Said, Mehdi Hadj
Raskin, Anne
Monnet-Corti, Virginie
DENTISTRY JOURNAL, 2022, 10 (05)
[3] Evaluating Surgical Complexity of Endoscopic Hysterectomy: An Inter-rater and Intra-rater Agreement Study of Novel Scoring Tool
Misal, Meenal
Girardo, Marlene
Behbehani, Sadikah
Bindra, Vimee
Hoffman, Mark R.
Lim, Wei How
Martin, Courtney
Mehta, Sukrant K.
Nensi, Alysha
Soares, Thiers
Taylor, Deborah
Wagner, Steve
Wright, Kelly N.
Wasson, Megan N.
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2022, 29 (05) : 683 - 690
[4] The Smile Esthetic Index (SEI): A method to measure the esthetics of the smile. An intra-rater and inter-rater agreement study
Rotunda, Roberto
Nieri, Michele
Bonaccini, Daniele
Mori, Massimiliano
Lambert, Elena
Massironi, Domenico
Giachetti, Luca
Franchi, Lorenzo
Venezia, Piero
Cavalcanti, Raffaele
Bondi, Elena
Farneti, Mauro
Pinchi, Vilma
Buti, Jacopo
EUROPEAN JOURNAL OF ORAL IMPLANTOLOGY, 2015, 8 (04) : 397 - 403
[5] Assessment of inter-rater and intra-rater reliability of the Luna EMG robot as a tool for assessing upper limb proprioception in patients with stroke-a prospective observational study
Leszczak, Justyna
Pniak, Bogumila
Druzbicki, Mariusz
Poswiata, Anna
Mikulski, Michal
Roksela, Anna
Guzik, Agnieszka
PEERJ, 2024, 12
[6] Inter-rater Agreement in Three Perfusion-Computed Tomography Evaluation Methods before Endovascular Therapy for Acute Ischemic Stroke
Khaw, A. V.
Angermaier, A.
Michel, P.
Kirsch, M.
Kessler, C.
Langner, S.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 2016, 25 (04) : 960 - 968
[7] Measurement of glenohumeral joint translation using real-time ultrasound imaging: A physiotherapist and sonographer intra-rater and inter-rater reliability study
Rathi, Sangeeta
Taylor, Nicholas F.
Gee, Jamie
Green, Rodney A.
MANUAL THERAPY, 2016, 26 : 110 - 116
[8] Total and regional ASPECT score for non-contrast CT, CT angiography, and CT perfusion: inter-rater agreement and its association with the final infarction in acute ischemic stroke patients
Chu, Yue
Ma, Gao
Xu, Xiao-Quan
Lu, Shan-Shan
Cao, Yue-Zhou
Shi, Hai-Bin
Liu, Sheng
Wu, Fei-Yun
ACTA RADIOLOGICA, 2022, 63 (08) : 1093 - 1101
[9] Role of Favorable Perfusion Imaging in Predicting the Outcome of Patients with Acute Ischemic Stroke due to Large Vessel Occlusion Undergoing Effective Thrombectomy: A Single-Center Study
Di Iorio, Riccardo
Pilato, Fabio
Valente, Iacopo
Laurienzo, Andrea
Gaudino, Simona
Frisullo, Giovanni
Profice, Paolo
Cottonaro, Simone
Alexandre, Andrea
Caliandro, Pietro
Morosetti, Roberta
Lozupone, Emilio
D'Argento, Francesco
Pedicelli, Alessandro
Colosimo, Cesare
Calabresi, Paolo
Della Marca, Giacomo
Broccolini, Aldobrando
CEREBROVASCULAR DISEASES EXTRA, 2021, 11 (01): : 1 - 8

← 1 →