1. Inter-observer variability of radiologists for Cambridge classification of chronic pancreatitis using CT and MRCP: results from a large multi-center study
- Author
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Kareem Mawad, Ashley Wachsman, Darwin L. Conwell, Liang Li, Naoki Takahashi, Joseph R. Grajo, Carlos A. Farinas, Savitri Appana, Anil K. Dasyam, Temel Tirkes, Stephanie T. Chang, Zarine K. Shah, and Dhiraj Yadav
- Subjects
Adult ,Male ,Cholangiopancreatography, Magnetic Resonance ,Urology ,Concordance ,Contrast Media ,Severity of Illness Index ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Cohen's kappa ,Pancreatitis, Chronic ,Radiologists ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Observer Variation ,Magnetic resonance cholangiopancreatography ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,Cohort ,Pancreatitis ,Female ,Nuclear medicine ,business ,Observer variation ,Tomography, X-Ray Computed ,Kappa - Abstract
PURPOSE: Determine inter-observer variability among radiologists in assigning Cambridge Classification (CC) of chronic pancreatitis (CP) based on magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) and contrast-enhanced CT (CECT). METHODS: Among 422 eligible subjects enrolled into the PROCEED study between 6/2017 and 8/2018, 39 were selected randomly for this study (chronic abdominal pain (n=8; CC of 0), suspected CP (n=22; CC of 0, 1 or 2) or definite CP (n=9; CC of 3 or 4). Each imaging was scored by the local radiologist (LRs) and three of five central radiologists (CRs) at other consortium sites. The CRs were blinded to clinical data and site information of the participants. We compared the CC score assigned by the LR with the consensus CC score assigned by the CRs. The weighted kappa statistic (K) was used to estimate the inter-observer agreement. RESULTS: For the majority of subjects (34/39), the group assignment by LR agreed with the consensus composite CT/MRCP score by the CRs (concordance ranging from 75% to 89% depending on cohort group). There was moderate agreement (63% and 67% agreed, respectively) between CRs and LRs in both the CT score (weighted Kappa [95% CI] = 0.56 [0.34, 0.78]; p-value = 0.57) and the MR score (weighted Kappa [95% CI] = 0.68 [0.49, 0.86]; p-value = 0.72). The composite CT/MR score showed moderate agreement (weighted Kappa [95% CI] = 0.62 [0.43, 0.81]; p-value = 0.80). CONCLUSION: There is a high degree of concordance among radiologists for assignment of CC using MRI and CT.
- Published
- 2020