Inter- and intra-observer repeatability of aortic annulus measurements on screening CT for transcatheter aortic valve replacement (TAVR): Implications for appropriate device sizing. Eur J Radiol 2018 Aug;105:209-215
Date
07/19/2018Pubmed ID
30017282Pubmed Central ID
PMC6082406DOI
10.1016/j.ejrad.2018.06.003Scopus ID
2-s2.0-85048745007 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
OBJECTIVES: To investigate intra- and inter-observer repeatability of aortic annulus CT measurements for transcatheter aortic valve replacement (TAVR) by readers with different levels of experience and evaluate the impact of different multi-reader paradigms to improve prosthesis sizing.
METHODS: 82 TAVR screening CTAs were evaluated twice by three raters with six (R1 = radiologist), three (R2 = 3D-laboratory technician) or zero (R3 = medical student) years of experience. Results were translated into hypothetical TAVR size recommendations. Intra- and inter-observer repeatability between single readers and three different multi-reader paradigms ([A]: two readers, [B]: three readers, or [C]: two readers + an optional third reader) were evaluated.
RESULTS: Intra-observer variability did not differ significantly (range: 50.1-67.8mm2). However, we found significant differences in mean inter-observer variance (p = 0.001). Multi-reader paradigms led to significantly increased precision (lower variability) for scenarios [B] and [C] (p = 0.03, p < 0.05). Compared to single readers, all multi-reader strategies clearly lowered the rate of discrepant device size categorization between repeated measurements (22-26% to 5-10%).
CONCLUSIONS: Aortic annulus CT measurements for TAVR are highly reproducible. Multi-reader strategies provide higher precision than evaluations from single readers with different levels of experience and could effectively be implemented with two readers and an optional third reader (Paradigm C) in a clinical setting.
Author List
Knobloch G, Sweetman S, Bartels C, Raval A, Gimelli G, Jacobson K, Lozonschi L, Kohmoto T, Osaki S, François C, Nagle SAuthor
Takushi Kohmoto PhD, MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Aortic Valve
Aortic Valve Stenosis
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Male
Middle Aged
Observer Variation
Prosthesis Design
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Retrospective Studies
Tomography, X-Ray Computed
Transcatheter Aortic Valve Replacement
