MRVAS-introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis
Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI...
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| Veröffentlicht in: | Rheumatology (Oxford, England) England), 2024-10, Vol.63 (10), p.2781-2790 |
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| creator | Froehlich, Matthias Guggenberger, Konstanze V Vogt, Marius Mihatsch, Patrick W Dalla Torre, Giulia Werner, Rudolf A Gernert, Michael Strunz, Patrick P Portegys, Jan Weng, Andreas M Schmalzing, Marc Bley, Thorsten A |
| description | Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI was assessed by four readers with different levels of experience.
A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0-20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen's κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS.
Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P |
| doi_str_mv | 10.1093/rheumatology/keae056 |
| format | Article |
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A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0-20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen's κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS.
Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P < 0.001) for all pairs (κ range 0.78-0.98). No significant differences between ExRs and InRs were observed (P = 0.38).
The proposed MRVAS allows standardized scoring of inflammation in GCA and achieved high agreement rates in a prospective setting.</description><identifier>ISSN: 1462-0324</identifier><identifier>ISSN: 1462-0332</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/keae056</identifier><identifier>PMID: 38305463</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Aged, 80 and over ; Aorta - diagnostic imaging ; Aorta - pathology ; Female ; Giant Cell Arteritis - diagnostic imaging ; Humans ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Severity of Illness Index</subject><ispartof>Rheumatology (Oxford, England), 2024-10, Vol.63 (10), p.2781-2790</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c186t-60a62a8fd0fd56348032426177312c67fc04143e88ff6242fff7d7fa70f9c7ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38305463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Froehlich, Matthias</creatorcontrib><creatorcontrib>Guggenberger, Konstanze V</creatorcontrib><creatorcontrib>Vogt, Marius</creatorcontrib><creatorcontrib>Mihatsch, Patrick W</creatorcontrib><creatorcontrib>Dalla Torre, Giulia</creatorcontrib><creatorcontrib>Werner, Rudolf A</creatorcontrib><creatorcontrib>Gernert, Michael</creatorcontrib><creatorcontrib>Strunz, Patrick P</creatorcontrib><creatorcontrib>Portegys, Jan</creatorcontrib><creatorcontrib>Weng, Andreas M</creatorcontrib><creatorcontrib>Schmalzing, Marc</creatorcontrib><creatorcontrib>Bley, Thorsten A</creatorcontrib><title>MRVAS-introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis</title><title>Rheumatology (Oxford, England)</title><addtitle>Rheumatology (Oxford)</addtitle><description>Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI was assessed by four readers with different levels of experience.
A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0-20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen's κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS.
Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P < 0.001) for all pairs (κ range 0.78-0.98). No significant differences between ExRs and InRs were observed (P = 0.38).
The proposed MRVAS allows standardized scoring of inflammation in GCA and achieved high agreement rates in a prospective setting.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aorta - diagnostic imaging</subject><subject>Aorta - pathology</subject><subject>Female</subject><subject>Giant Cell Arteritis - diagnostic imaging</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><issn>1462-0324</issn><issn>1462-0332</issn><issn>1462-0332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNUU1P3DAQtaqiLtD-A1T52EvAjrNO9ogQbZFASEB7jWbt8a5pYoPHkRp-Ar-aRCyI04zevDdfj7EjKY6lWKmTtMWhhxy7uBlP_iGgWOpPbF9WuiyEUuXn97ysFuyA6F4IsZSq-cIWqlFiWWm1z56vbv6e3hY-5BTtYHzYcOCUIVhI1j-h5T1sAmZveEKKAYJBTiammUkjZey5i4kDERLNYN4ix_8ZQ-bRcR9cB_28Zxr5ekgWw4TxjYepbrDrOKSMyWdPX9meg47w2y4esj8_z-_OfheX178uzk4vCyMbnQstQJfQOCucXWpVNfOBpZZ1rWRpdO2MqGSlsGmc01PFOVfb2kEt3MrUsFaH7Mdr34cUHwek3Pae5lUgYByoLVflSipRN3KiVq9UkyJRQtc-JN9DGlsp2tmF9qML7c6FSfZ9N2FY92jfRW9vVy99v4u1</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Froehlich, Matthias</creator><creator>Guggenberger, Konstanze V</creator><creator>Vogt, Marius</creator><creator>Mihatsch, Patrick W</creator><creator>Dalla Torre, Giulia</creator><creator>Werner, Rudolf A</creator><creator>Gernert, Michael</creator><creator>Strunz, Patrick P</creator><creator>Portegys, Jan</creator><creator>Weng, Andreas M</creator><creator>Schmalzing, Marc</creator><creator>Bley, Thorsten A</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241001</creationdate><title>MRVAS-introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis</title><author>Froehlich, Matthias ; Guggenberger, Konstanze V ; Vogt, Marius ; Mihatsch, Patrick W ; Dalla Torre, Giulia ; Werner, Rudolf A ; Gernert, Michael ; Strunz, Patrick P ; Portegys, Jan ; Weng, Andreas M ; Schmalzing, Marc ; Bley, Thorsten A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c186t-60a62a8fd0fd56348032426177312c67fc04143e88ff6242fff7d7fa70f9c7ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aorta - diagnostic imaging</topic><topic>Aorta - pathology</topic><topic>Female</topic><topic>Giant Cell Arteritis - diagnostic imaging</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Froehlich, Matthias</creatorcontrib><creatorcontrib>Guggenberger, Konstanze V</creatorcontrib><creatorcontrib>Vogt, Marius</creatorcontrib><creatorcontrib>Mihatsch, Patrick W</creatorcontrib><creatorcontrib>Dalla Torre, Giulia</creatorcontrib><creatorcontrib>Werner, Rudolf A</creatorcontrib><creatorcontrib>Gernert, Michael</creatorcontrib><creatorcontrib>Strunz, Patrick P</creatorcontrib><creatorcontrib>Portegys, Jan</creatorcontrib><creatorcontrib>Weng, Andreas M</creatorcontrib><creatorcontrib>Schmalzing, Marc</creatorcontrib><creatorcontrib>Bley, Thorsten A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Rheumatology (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Froehlich, Matthias</au><au>Guggenberger, Konstanze V</au><au>Vogt, Marius</au><au>Mihatsch, Patrick W</au><au>Dalla Torre, Giulia</au><au>Werner, Rudolf A</au><au>Gernert, Michael</au><au>Strunz, Patrick P</au><au>Portegys, Jan</au><au>Weng, Andreas M</au><au>Schmalzing, Marc</au><au>Bley, Thorsten A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MRVAS-introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis</atitle><jtitle>Rheumatology (Oxford, England)</jtitle><addtitle>Rheumatology (Oxford)</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>63</volume><issue>10</issue><spage>2781</spage><epage>2790</epage><pages>2781-2790</pages><issn>1462-0324</issn><issn>1462-0332</issn><eissn>1462-0332</eissn><abstract>Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI was assessed by four readers with different levels of experience.
A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0-20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen's κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS.
Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P < 0.001) for all pairs (κ range 0.78-0.98). No significant differences between ExRs and InRs were observed (P = 0.38).
The proposed MRVAS allows standardized scoring of inflammation in GCA and achieved high agreement rates in a prospective setting.</abstract><cop>England</cop><pmid>38305463</pmid><doi>10.1093/rheumatology/keae056</doi><tpages>10</tpages></addata></record> |
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| ispartof | Rheumatology (Oxford, England), 2024-10, Vol.63 (10), p.2781-2790 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Aged Aged, 80 and over Aorta - diagnostic imaging Aorta - pathology Female Giant Cell Arteritis - diagnostic imaging Humans Magnetic Resonance Imaging - methods Male Middle Aged Observer Variation Reproducibility of Results Severity of Illness Index |
| title | MRVAS-introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis |
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