Interobserver reliability in the interpretation of diagnostic lumbar MRI and nuclear imaging

Mulconrey, Daniel S.; Knight, Reginald Q.; Bramble, James D.; Paknikar, Subhash; Harty, Patrick A.

doi:10.1016/j.spinee.2005.08.011

Cited by 50 publications

(33 citation statements)

References 17 publications

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“…The investigation of Mulconrey et al (15), involving the rating of 17 lumbar spine MR examination cases (at 80 levels) by four readers, revealed good interobserver agreement ( ϭ 0.669). Our results for interobserver reliability were lower and borderline good overall ( ϭ 0.59).…”

Section: Musculoskeletal Imaging: Mr Imaging Of Lumbar Spinementioning

confidence: 94%

“…Some prior work regarding observer performance in the interpretation of lumbosacral spine MR imaging data has been done in a variety of settings involving intervertebral disk and other abnormalities (14)(15)(16)(17)(18)(19). Results of these prior investigations suggest that the reliability of characterizing non-disk contour lumbar spine MR imaging findings is reasonable, and we considered whether these might serve as predictors of outcome.…”

mentioning

confidence: 99%

“…Results of these prior investigations suggest that the reliability of characterizing non-disk contour lumbar spine MR imaging findings is reasonable, and we considered whether these might serve as predictors of outcome. However, these prior studies were limited by their focus on only one finding (14,(16)(17)(18)(19), small sample size of fewer than 25 MR examination cases (15), and having fewer than four readers (14,(17)(18)(19). These investigations were also focused primarily on clinical diagnostic work, whereas we were interested in the effectiveness of MR imaging findings as potential predictors of outcome.…”

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confidence: 99%

See 2 more Smart Citations

Lumbar Spine: Reliability of MR Imaging Findings

Carrino¹,

Lurie²,

Tosteson³

et al. 2009

Radiology

171

123

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Purpose:To characterize the inter-and intraobserver variability of qualitative, non-disk contour degenerative findings of the lumbar spine at magnetic resonance (MR) imaging. Materials and Methods:The case accrual method used to perform this institutional review board-approved, HIPAA-compliant retrospective study was the random selection of 111 interpretable MR examination cases of subjects from the Spine Patient Outcomes Research Trial. The subjects were aged 18 -87 years (mean, 53 years Ϯ 16 [standard deviation]). Four independent readers rated the cases according to defined criteria. A subsample of 40 MR examination cases was selected for reevaluation at least 1 month later. The following findings were assessed: spondylolisthesis, disk degeneration, marrow endplate abnormality (Modic changes), posterior anular hyperintense zone (HIZ), and facet arthropathy. Inter-and intraobserver agreement in rating the data was summarized by using weighted statistics. Results:Interobserver agreement was good ( ϭ 0.66) in rating disk degeneration and moderate in rating spondylolisthesis ( Conclusion:The interpretation of general lumbar spine MR characteristics has sufficient reliability to warrant the further evaluation of these features as potential prognostic indicators.

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Section: Musculoskeletal Imaging: Mr Imaging Of Lumbar Spinementioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Lumbar Spine: Reliability of MR Imaging Findings

Carrino¹,

Lurie²,

Tosteson³

et al. 2009

Radiology

171

123

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“…In all these cases, consensus was obtained without difficulties by authors 1 and 5. A total of 60 papers were excluded after review; 27 as they dealt with specific LBP conditions ( Table 2) and 33 for other reasons: one review article [55], four case reports [7,27,129,148], one double publication [90], one of two studies reporting data from the same study sample [80], ten for evaluating signal changes other than those related to the endplate [6,20,51,53,71,113,116,139,146,150], and eight articles because they did not report the exact numbers needed to calculate the prevalence rates of VESC [4,10,109,110,114,122,133,141]. Finally, eight articles were excluded because the study samples were selected on the basis of the presence of VESC [41, 50,56,63,68,134,137,149].…”

Section: Review Processmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

397

297

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The prevalence of ''vertebral endplate signal changes'' (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 9 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.

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“…In several studies the observer variability has been reported as rather large for each of the separate studies [3,7,8,[10][11][12][16][17][18]. However, based on our experiences with the classification of MC, we have discovered (not surprisingly) that there can be wide variations in the interpretation of MC and when to report it as a significant finding.…”

Section: Observer Variabilitymentioning

confidence: 72%

Reply to the letter to the editor of João Luiz Pinheiro Franco

et al. 2008

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We would like to express our appreciation of the comments to our paper ''Modic changes (MC) and their associations with clinical findings '' [10]. In our paper, we compare several clinical findings in people with Modic Changes and Disc Degeneration, degeneration only and no MRI findings. The main suggestion in the letter is that Modic Type 1 and Type 2 are different in relation to histopathological findings and should therefore be treated as two distinct subgroups in future studies (REF letter). We do agree with this notion. In our analyses we did not find statistically significant differences and, therefore, we did not report Modic Type 1 and 2 separately. However, in relation to the clinical picture (association with low back pain (LBP)), the distinction between different types of MC is challenging. Several factors such as classification of MC, observer variability and the clinical outcomes could influence the reporting of Modic changes and thus affect the results of the studies.

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Interobserver reliability in the interpretation of diagnostic lumbar MRI and nuclear imaging

Cited by 50 publications

References 17 publications

Lumbar Spine: Reliability of MR Imaging Findings

Lumbar Spine: Reliability of MR Imaging Findings

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Reply to the letter to the editor of João Luiz Pinheiro Franco

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