Inter- and Intrarater Agreement on the Outcome of Endovascular Treatment of Aneurysms Using MRA

Jamali, Sarah; Fahed, Robert; Gentric, Jean-Christophe; Létourneau-Guillon, Laurent; Raoult, Hélène; Fan, Bing; Estrade, Laurent; Nguyen, Thanh N.; Tollard, É.; Ferré, Jean-Christophe; Iancu, Daniela; Naggara, Olivier; Chagnon, Miguel; Weill, Alain; Roy, Daniel; Fox, Allan J.; Kallmes, David F.; Raymond, Jean

doi:10.3174/ajnr.a4609

Cited by 8 publications

(3 citation statements)

References 37 publications

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“…It is an invasive method associated with rare but potential risks . Alternatively, 3D time‐of‐flight (3D‐TOF) and contrast enhanced (CE) MRA are more comfortable for the patient, but are associated with diagnostic inaccuracy due to slow flow saturation or susceptibility and shielding artifacts caused by the metallic implants.…”

Section: Introductionmentioning

confidence: 99%

Neurovascular stent artifacts in 3D‐TOF and 3D‐PCMRI: Influence of stent design on flow measurement

Bouillot

Brina

Delattre

et al. 2018

Magnetic Resonance in Med

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Section: Introductionmentioning

confidence: 99%

Neurovascular stent artifacts in 3D‐TOF and 3D‐PCMRI: Influence of stent design on flow measurement

Bouillot

Brina

Delattre

et al. 2018

Magnetic Resonance in Med

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“…Interpretation of a K values was given in accordance with Landis and Koch. 25 Comparisons of proportions of ratings between prespecified aneurysm and rater subgroups as well as the strength of the association between the raters' angiographic verdict and the management of the patient were evaluated using the Fisher exact test followed by a Cramer V test, with a significance threshold of .05.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study

Benomar

Farzin

Gevry

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Noninvasive angiography is commonly used to assess the outcome of surgical or endovascular treatment of intracranial aneurysms in clinical series or randomized trials. We sought to assess whether a standardized 3-grade classification system could be reliably used to compare the CTA and MRA results of both treatments. MATERIALS AND METHODS:An electronic portfolio composed of CTAs of 30 clipped and MRAs of 30 coiled aneurysms was independently evaluated by 24 raters of diverse experience and training backgrounds. Twenty raters performed a second evaluation 1 month later. Raters were asked which angiographic grade and management decision (retreatment; close or long-term follow-up) would be most appropriate for each case. Agreement was analyzed using the Krippendorff a (a K ) statistic, and the relationship between angiographic grade and clinical management choice, using the Fisher exact and Cramer V tests. RESULTS:Interrater agreement was substantial (a K ¼ 0.63; 95% CI, 0.55-0.70); results were slightly better for MRA results of coiling (a K ¼ 0.69; 95% CI, 0.56-0.76) than for CTA results of clipping (a K ¼ 0.58; 95% CI, 0.44-0.69). Intrarater agreement was substantial to almost perfect. Interrater agreement regarding clinical management was moderate for both clipped (a K ¼ 0.49; 95% CI, 0.32-0.61) and coiled subgroups (a K ¼ 0.47; 95% CI, 0.34-0.54). The choice of clinical management was strongly associated with the size of the residuum (mean Cramer V ¼ 0.77 [SD, 0.14]), but complete occlusions (grade 1) were followed more closely after coiling than after clipping (P ¼ .01). CONCLUSIONS:A standardized 3-grade scale was found to be a reliable and clinically meaningful tool to compare the results of clipping and coiling of aneurysms using CTA or MRA.

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“…The inter-rater agreement regarding this dichotomized angiographic endpoint has previously been shown to be acceptable. 12,13 Angiographic results will be scored according to a previously published classification system 14 as complete obliteration, residual neck or residual aneurysm, and groups will be compared for results initially at the end of treatment and at follow-up at 12 ± 2 months. Recurrences will be recorded (present or absent) on CRFs as they are discovered, either at the routine follow-up assessments or as clinical symptoms appear any time during the 12 months that follow the intervention.…”

Section: Methodsmentioning

confidence: 99%

Endovascular treatment of aneurysms and platinum coil caliber: Study protocol of a randomized, controlled trial

et al. 2016

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Background Endovascular coil embolization of cerebral aneurysms is an effective treatment for the prevention of aneurysm rebleeding after subarachnoid hemorrhage. It is also often used in unruptured aneurysms, but it is associated with aneurysm remnants and recurrences in up to 20%–33% of patients. We hypothesized that better aneurysm occlusion rates can be achieved with coils of larger caliber. Methods The Does Embolization with Larger coils lead to better Treatment of Aneurysms (DELTA) trial is an investigator-initiated, multicenter, prospective, randomized, controlled clinical trial. To test the hypothesis that 15-caliber coiling systems are superior to 10-caliber coils, 564 patients with aneurysms measuring 4–12 mm will be randomized 1:1 to embolization with either 10-caliber coils exclusively (control group) or the highest safely achievable proportion of 15-caliber coils (intervention group). The primary efficacy endpoint of the trial is the occurrence of a major recurrence or a residual aneurysm at one year. A pilot phase of 165 patients will be conducted to verify feasibility of the coiling strategy, compliance to treatment allocation, safety of a 15-caliber platinum coil embolization strategy, recruitment rates, and the capacity to improve packing density. Discussion The DELTA trial will test the hypothesis that the use of coils of larger caliber can improve angiographic results of endovascular coiling.

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Inter- and Intrarater Agreement on the Outcome of Endovascular Treatment of Aneurysms Using MRA

Abstract: BACKGROUND AND PURPOSE:Patients treated with coiling are often followed by MR angiography. Our objective was to assess the inter-and intraobserver agreement in diagnosing aneurysm remnants and recurrences by using multimodality imaging, including TOF MRA.

Cited by 8 publications

References 37 publications

Neurovascular stent artifacts in 3D‐TOF and 3D‐PCMRI: Influence of stent design on flow measurement

Neurovascular stent artifacts in 3D‐TOF and 3D‐PCMRI: Influence of stent design on flow measurement

Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study

Endovascular treatment of aneurysms and platinum coil caliber: Study protocol of a randomized, controlled trial

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