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Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans
Background: Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant)...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783397/ https://www.ncbi.nlm.nih.gov/pubmed/33414757 http://dx.doi.org/10.3389/fneur.2020.593098 |
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author | Lun, Ronda Walker, Gregory B. Guenego, Adrien Kassab, Mohammed Portela, Eduardo Yogendrakumar, Vignan Medvedev, George Wong, Ken Shamy, Michel Dowlatshahi, Dar Fahed, Robert |
author_facet | Lun, Ronda Walker, Gregory B. Guenego, Adrien Kassab, Mohammed Portela, Eduardo Yogendrakumar, Vignan Medvedev, George Wong, Ken Shamy, Michel Dowlatshahi, Dar Fahed, Robert |
author_sort | Lun, Ronda |
collection | PubMed |
description | Background: Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management. Aims: Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans. Methods: A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's K statistics. Results: Overall agreement on blood and/ or contrast presence was only fair, k = 0.291 (95% CI = 0.273–0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training. Conclusion: Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases. |
format | Online Article Text |
id | pubmed-7783397 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77833972021-01-06 Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans Lun, Ronda Walker, Gregory B. Guenego, Adrien Kassab, Mohammed Portela, Eduardo Yogendrakumar, Vignan Medvedev, George Wong, Ken Shamy, Michel Dowlatshahi, Dar Fahed, Robert Front Neurol Neurology Background: Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management. Aims: Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans. Methods: A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's K statistics. Results: Overall agreement on blood and/ or contrast presence was only fair, k = 0.291 (95% CI = 0.273–0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training. Conclusion: Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases. Frontiers Media S.A. 2020-12-22 /pmc/articles/PMC7783397/ /pubmed/33414757 http://dx.doi.org/10.3389/fneur.2020.593098 Text en Copyright © 2020 Lun, Walker, Guenego, Kassab, Portela, Yogendrakumar, Medvedev, Wong, Shamy, Dowlatshahi and Fahed. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Lun, Ronda Walker, Gregory B. Guenego, Adrien Kassab, Mohammed Portela, Eduardo Yogendrakumar, Vignan Medvedev, George Wong, Ken Shamy, Michel Dowlatshahi, Dar Fahed, Robert Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans |
title | Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans |
title_full | Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans |
title_fullStr | Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans |
title_full_unstemmed | Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans |
title_short | Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans |
title_sort | is this contrast? is this blood? an agreement study on post-thrombectomy computed tomography scans |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783397/ https://www.ncbi.nlm.nih.gov/pubmed/33414757 http://dx.doi.org/10.3389/fneur.2020.593098 |
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