Interexaminer Difference in Infarct Volume Measurements on MRI : A Source of Variance in Stroke Research
The measurement of ischemic lesion volume on diffusion- (DWI) and perfusion-weighted MRI (PWI) is examiner dependent. We sought to quantify the variance imposed by measurement error in DWI and PWI lesion volume measurements in ischemic stroke. Fifty-eight consecutive patients with DWI and PWI within...
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| Veröffentlicht in: | Stroke (1970) 2008-04, Vol.39 (4), p.1171-1176 |
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| container_title | Stroke (1970) |
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| creator | AY, Hakan ARSAVA, E. Murat VANGEL, Mark ONER, Banu MINGWANG ZHU WU, Ona SINGHAL, Aneesh KOROSHETZ, Walter J SORENSEN, A. Gregory |
| description | The measurement of ischemic lesion volume on diffusion- (DWI) and perfusion-weighted MRI (PWI) is examiner dependent. We sought to quantify the variance imposed by measurement error in DWI and PWI lesion volume measurements in ischemic stroke.
Fifty-eight consecutive patients with DWI and PWI within 12 hours of symptom onset and follow-up MRI on >or= day-5 were studied. Two radiologists blinded to each other measured lesion volumes by manual outlining on each image. Interexaminer reliability was evaluated by intraclass correlation coefficients (ICC) and relative paired difference or RPD (ratio of difference between 2 measurements to their mean). The ratio of between-examiner variability to between-subject variability (variance ratio) was calculated for each imaging parameter.
The correlation (ICC) between examiners ranged from 0.93 to 0.99. The median RPD was 10.0% for DWI, 14.1% for mean transit time, 18.9% for cerebral blood flow, 21.0% for cerebral blood volume, 16.8% for DWI/MTT mismatch, and 6.3% for chronic T2-weighted images. There was negative correlation between RPD and lesion volume in all but chronic T2-weighted images. The variance ratio ranged between 0.02 and 0.10.
Despite high correlation between volume measurements of abnormal regions on DWI and PWI by different examiners, substantial differences in individual measurements can still occur. The magnitude of variance from measurement error is primarily determined by the type of imaging and lesion volume. Minimizing this source of variance will better enable imaging to deliver on its promise of smaller sample size. |
| doi_str_mv | 10.1161/STROKEAHA.107.502104 |
| format | Article |
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Fifty-eight consecutive patients with DWI and PWI within 12 hours of symptom onset and follow-up MRI on >or= day-5 were studied. Two radiologists blinded to each other measured lesion volumes by manual outlining on each image. Interexaminer reliability was evaluated by intraclass correlation coefficients (ICC) and relative paired difference or RPD (ratio of difference between 2 measurements to their mean). The ratio of between-examiner variability to between-subject variability (variance ratio) was calculated for each imaging parameter.
The correlation (ICC) between examiners ranged from 0.93 to 0.99. The median RPD was 10.0% for DWI, 14.1% for mean transit time, 18.9% for cerebral blood flow, 21.0% for cerebral blood volume, 16.8% for DWI/MTT mismatch, and 6.3% for chronic T2-weighted images. There was negative correlation between RPD and lesion volume in all but chronic T2-weighted images. The variance ratio ranged between 0.02 and 0.10.
Despite high correlation between volume measurements of abnormal regions on DWI and PWI by different examiners, substantial differences in individual measurements can still occur. The magnitude of variance from measurement error is primarily determined by the type of imaging and lesion volume. Minimizing this source of variance will better enable imaging to deliver on its promise of smaller sample size.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.107.502104</identifier><identifier>PMID: 18292377</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cerebral Infarction - diagnostic imaging ; Cerebral Infarction - pathology ; Diffusion Magnetic Resonance Imaging - standards ; Diffusion Magnetic Resonance Imaging - statistics & numerical data ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Magnetic Resonance Angiography - standards ; Magnetic Resonance Angiography - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Models, Statistical ; Nervous system (semeiology, syndromes) ; Neurology ; Neuroradiography - standards ; Neuroradiography - statistics & numerical data ; Observer Variation ; Retrospective Studies ; Stroke - diagnostic imaging ; Stroke - pathology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2008-04, Vol.39 (4), p.1171-1176</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-fbe7002989cdbe6fce7b320c1e169581525037f755e3e161c5f0c7278e470873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3686,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20214817$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18292377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>AY, Hakan</creatorcontrib><creatorcontrib>ARSAVA, E. Murat</creatorcontrib><creatorcontrib>VANGEL, Mark</creatorcontrib><creatorcontrib>ONER, Banu</creatorcontrib><creatorcontrib>MINGWANG ZHU</creatorcontrib><creatorcontrib>WU, Ona</creatorcontrib><creatorcontrib>SINGHAL, Aneesh</creatorcontrib><creatorcontrib>KOROSHETZ, Walter J</creatorcontrib><creatorcontrib>SORENSEN, A. Gregory</creatorcontrib><title>Interexaminer Difference in Infarct Volume Measurements on MRI : A Source of Variance in Stroke Research</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>The measurement of ischemic lesion volume on diffusion- (DWI) and perfusion-weighted MRI (PWI) is examiner dependent. We sought to quantify the variance imposed by measurement error in DWI and PWI lesion volume measurements in ischemic stroke.
Fifty-eight consecutive patients with DWI and PWI within 12 hours of symptom onset and follow-up MRI on >or= day-5 were studied. Two radiologists blinded to each other measured lesion volumes by manual outlining on each image. Interexaminer reliability was evaluated by intraclass correlation coefficients (ICC) and relative paired difference or RPD (ratio of difference between 2 measurements to their mean). The ratio of between-examiner variability to between-subject variability (variance ratio) was calculated for each imaging parameter.
The correlation (ICC) between examiners ranged from 0.93 to 0.99. The median RPD was 10.0% for DWI, 14.1% for mean transit time, 18.9% for cerebral blood flow, 21.0% for cerebral blood volume, 16.8% for DWI/MTT mismatch, and 6.3% for chronic T2-weighted images. There was negative correlation between RPD and lesion volume in all but chronic T2-weighted images. The variance ratio ranged between 0.02 and 0.10.
Despite high correlation between volume measurements of abnormal regions on DWI and PWI by different examiners, substantial differences in individual measurements can still occur. The magnitude of variance from measurement error is primarily determined by the type of imaging and lesion volume. Minimizing this source of variance will better enable imaging to deliver on its promise of smaller sample size.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cerebral Infarction - diagnostic imaging</subject><subject>Cerebral Infarction - pathology</subject><subject>Diffusion Magnetic Resonance Imaging - standards</subject><subject>Diffusion Magnetic Resonance Imaging - statistics & numerical data</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Magnetic Resonance Angiography - standards</subject><subject>Magnetic Resonance Angiography - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Statistical</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuroradiography - standards</subject><subject>Neuroradiography - statistics & numerical data</subject><subject>Observer Variation</subject><subject>Retrospective Studies</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - pathology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkVtLAzEQhYMoWqv_QCQv-rZ1ctvs-lbqrVgR2uLrksYJru5Fk13Qf2-kiz76NMzwncPMHEJOGEwYS9nFar18vL-e3k0nDPREAWcgd8iIKS4TmfJsl4wARJ5wmecH5DCEVwDgIlP75IBlPOdC6xF5mTcdevw0ddmgp1elc7FtLNKyofPGGW87-tRWfY30AU3oPdbYdIG2DX1YzuklndJV2_soaB19Mr40g3jV-fYN6RIDRpOXI7LnTBXweKhjsr65Xs_uksXj7Xw2XSRWKNYlboM6rplnuX3eYOos6o3gYBmyNFdZvE6B0E4rhSKOmFUOrOY6Q6kh02JMzre277796DF0RV0Gi1VlGmz7UGiQQnL1P8ghTbnIIYJyC1rfhuDRFe--rI3_KhgUP0kUv0nEiS62SUTZ6eDfb2p8_hMNr4_A2QCYYE3lfHxcGX45Hm1kxrT4BjKnkJE</recordid><startdate>20080401</startdate><enddate>20080401</enddate><creator>AY, Hakan</creator><creator>ARSAVA, E. Murat</creator><creator>VANGEL, Mark</creator><creator>ONER, Banu</creator><creator>MINGWANG ZHU</creator><creator>WU, Ona</creator><creator>SINGHAL, Aneesh</creator><creator>KOROSHETZ, Walter J</creator><creator>SORENSEN, A. Gregory</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><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>7TK</scope><scope>7X8</scope></search><sort><creationdate>20080401</creationdate><title>Interexaminer Difference in Infarct Volume Measurements on MRI : A Source of Variance in Stroke Research</title><author>AY, Hakan ; ARSAVA, E. Murat ; VANGEL, Mark ; ONER, Banu ; MINGWANG ZHU ; WU, Ona ; SINGHAL, Aneesh ; KOROSHETZ, Walter J ; SORENSEN, A. Gregory</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-fbe7002989cdbe6fce7b320c1e169581525037f755e3e161c5f0c7278e470873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cerebral Infarction - diagnostic imaging</topic><topic>Cerebral Infarction - pathology</topic><topic>Diffusion Magnetic Resonance Imaging - standards</topic><topic>Diffusion Magnetic Resonance Imaging - statistics & numerical data</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Magnetic Resonance Angiography - standards</topic><topic>Magnetic Resonance Angiography - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Statistical</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuroradiography - standards</topic><topic>Neuroradiography - statistics & numerical data</topic><topic>Observer Variation</topic><topic>Retrospective Studies</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - pathology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AY, Hakan</creatorcontrib><creatorcontrib>ARSAVA, E. Murat</creatorcontrib><creatorcontrib>VANGEL, Mark</creatorcontrib><creatorcontrib>ONER, Banu</creatorcontrib><creatorcontrib>MINGWANG ZHU</creatorcontrib><creatorcontrib>WU, Ona</creatorcontrib><creatorcontrib>SINGHAL, Aneesh</creatorcontrib><creatorcontrib>KOROSHETZ, Walter J</creatorcontrib><creatorcontrib>SORENSEN, A. Gregory</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AY, Hakan</au><au>ARSAVA, E. Murat</au><au>VANGEL, Mark</au><au>ONER, Banu</au><au>MINGWANG ZHU</au><au>WU, Ona</au><au>SINGHAL, Aneesh</au><au>KOROSHETZ, Walter J</au><au>SORENSEN, A. Gregory</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interexaminer Difference in Infarct Volume Measurements on MRI : A Source of Variance in Stroke Research</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2008-04-01</date><risdate>2008</risdate><volume>39</volume><issue>4</issue><spage>1171</spage><epage>1176</epage><pages>1171-1176</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>The measurement of ischemic lesion volume on diffusion- (DWI) and perfusion-weighted MRI (PWI) is examiner dependent. We sought to quantify the variance imposed by measurement error in DWI and PWI lesion volume measurements in ischemic stroke.
Fifty-eight consecutive patients with DWI and PWI within 12 hours of symptom onset and follow-up MRI on >or= day-5 were studied. Two radiologists blinded to each other measured lesion volumes by manual outlining on each image. Interexaminer reliability was evaluated by intraclass correlation coefficients (ICC) and relative paired difference or RPD (ratio of difference between 2 measurements to their mean). The ratio of between-examiner variability to between-subject variability (variance ratio) was calculated for each imaging parameter.
The correlation (ICC) between examiners ranged from 0.93 to 0.99. The median RPD was 10.0% for DWI, 14.1% for mean transit time, 18.9% for cerebral blood flow, 21.0% for cerebral blood volume, 16.8% for DWI/MTT mismatch, and 6.3% for chronic T2-weighted images. There was negative correlation between RPD and lesion volume in all but chronic T2-weighted images. The variance ratio ranged between 0.02 and 0.10.
Despite high correlation between volume measurements of abnormal regions on DWI and PWI by different examiners, substantial differences in individual measurements can still occur. The magnitude of variance from measurement error is primarily determined by the type of imaging and lesion volume. Minimizing this source of variance will better enable imaging to deliver on its promise of smaller sample size.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>18292377</pmid><doi>10.1161/STROKEAHA.107.502104</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute Disease Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Cerebral Infarction - diagnostic imaging Cerebral Infarction - pathology Diffusion Magnetic Resonance Imaging - standards Diffusion Magnetic Resonance Imaging - statistics & numerical data Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Magnetic Resonance Angiography - standards Magnetic Resonance Angiography - statistics & numerical data Male Medical sciences Middle Aged Models, Statistical Nervous system (semeiology, syndromes) Neurology Neuroradiography - standards Neuroradiography - statistics & numerical data Observer Variation Retrospective Studies Stroke - diagnostic imaging Stroke - pathology Vascular diseases and vascular malformations of the nervous system |
| title | Interexaminer Difference in Infarct Volume Measurements on MRI : A Source of Variance in Stroke Research |
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