Multiple sclerosis

Interobserver agreement in reporting active lesions on serial brain MRI using conventional spin echo, fast spin echo, fast fluid-attenuated inversion recovery and post-contrast T1-weighted images

M. Rovaris, F. Barkhof, S. Bastianello, C. Gasperini, N. Tubridy, T. A. Yousry, M. P. Sormani, B. Viti, D. H. Miller, M. Filippi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Previous studies have addressed the question of the precision in assessing multiple sclerosis (MS) activity by counting enhancing lesions on gadolinium enhanced brain magnetic resonance imaging (MRI). However, counting the active lesions on serial unenhanced MRI obtained by various pulse sequences has not been yet considered. We compared the interobserver levels of agreement in reporting active MS lesions on serial enhanced and unenhanced MRI to assess whether the use of various unenhanced techniques may change the degree of interobserver measurement reproducibility. Dual-echo conventional spin echo (CSE), dual-echo fast spin echo (FSE), fast fluid-attenuated inversion recovery (FLAIR) and Gd-enhanced T1-weighted brain MRI were obtained from five MS patients at baseline and monthly for 2 months. Six experienced observers independently identified and counted active MS lesions on the two follow-up MRI scans. Active lesions were considered to be all the enhancing lesions and any new or enlarging lesion on enhanced and unenhanced scans. Interobserver levels of agreement were calculated by weighted κ values. Very good agreement was reached only for counting total and new Gd-enhancing lesions. Good agreement was achieved for counting new lesions on the three unenhanced techniques, whereas the agreement for counting enlarging lesions was poor with all the MRI techniques. The level of agreement was significantly heterogeneous for various MRI techniques but not for various lesion sites. These results confirm that counting enhancing lesions is the most reliable method for assessing MS activity, but the use of any of the available unenhanced MRI techniques did not result in different levels of interobserver agreement when reporting new and enlarging MS lesions on serial scans.

Original languageEnglish
Pages (from-to)920-925
Number of pages6
JournalJournal of Neurology
Volume246
Issue number10
DOIs
Publication statusPublished - 1999

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Multiple Sclerosis
Magnetic Resonance Imaging
Brain
Gadolinium

Keywords

  • Disease activity
  • Fast fluid-attenuated inversion recovery
  • Fast spin echo
  • Magnetic resonance imaging
  • Multiple sclerosis
  • Reproducibility

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Multiple sclerosis : Interobserver agreement in reporting active lesions on serial brain MRI using conventional spin echo, fast spin echo, fast fluid-attenuated inversion recovery and post-contrast T1-weighted images. / Rovaris, M.; Barkhof, F.; Bastianello, S.; Gasperini, C.; Tubridy, N.; Yousry, T. A.; Sormani, M. P.; Viti, B.; Miller, D. H.; Filippi, M.

In: Journal of Neurology, Vol. 246, No. 10, 1999, p. 920-925.

Research output: Contribution to journalArticle

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abstract = "Previous studies have addressed the question of the precision in assessing multiple sclerosis (MS) activity by counting enhancing lesions on gadolinium enhanced brain magnetic resonance imaging (MRI). However, counting the active lesions on serial unenhanced MRI obtained by various pulse sequences has not been yet considered. We compared the interobserver levels of agreement in reporting active MS lesions on serial enhanced and unenhanced MRI to assess whether the use of various unenhanced techniques may change the degree of interobserver measurement reproducibility. Dual-echo conventional spin echo (CSE), dual-echo fast spin echo (FSE), fast fluid-attenuated inversion recovery (FLAIR) and Gd-enhanced T1-weighted brain MRI were obtained from five MS patients at baseline and monthly for 2 months. Six experienced observers independently identified and counted active MS lesions on the two follow-up MRI scans. Active lesions were considered to be all the enhancing lesions and any new or enlarging lesion on enhanced and unenhanced scans. Interobserver levels of agreement were calculated by weighted κ values. Very good agreement was reached only for counting total and new Gd-enhancing lesions. Good agreement was achieved for counting new lesions on the three unenhanced techniques, whereas the agreement for counting enlarging lesions was poor with all the MRI techniques. The level of agreement was significantly heterogeneous for various MRI techniques but not for various lesion sites. These results confirm that counting enhancing lesions is the most reliable method for assessing MS activity, but the use of any of the available unenhanced MRI techniques did not result in different levels of interobserver agreement when reporting new and enlarging MS lesions on serial scans.",
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AU - Barkhof, F.

AU - Bastianello, S.

AU - Gasperini, C.

AU - Tubridy, N.

AU - Yousry, T. A.

AU - Sormani, M. P.

AU - Viti, B.

AU - Miller, D. H.

AU - Filippi, M.

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