Reliability and Agreement of 2D and 3D Measurements on MRAs for Growth Assessment of Unruptured Intracranial Aneurysms
Timmins, Kimberley; Kuijf, Hugo; Vergouwen, Mervyn; Otten, Maarten; Ruigrok, Ynte; Velthuis, BK; van der Schaaf, Irene
(2021) American Journal of Neuroradiology, volume 42, issue 9, pp. 1598 - 1603
(Article)
Abstract
BACKGROUND AND PURPOSE: Reliable and reproducible measurement of unruptured intracranial aneurysm growth is important for unruptured intracranial aneurysm rupture risk assessment. This study aimed to compare the reliability and reproducibility of 2D and 3D growth measurements of unruptured intracranial aneurysms. MATERIALS AND METHODS: 2D height, width, and neck and 3D
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volume measurements of unruptured intracranial aneurysms on baseline and follow-up TOF-MRAs were performed by two observers. The reliability of individual 2D and 3D measurements and of change (growth) between paired scans was assessed (intraclass correlation coefficient) and stratified for aneurysm location. The smallest detectable change on 2D and 3D was determined. Proportions of growing aneurysms were compared, and Bland-Altman plots were created. RESULTS: Seventy-two patients with 84 unruptured intracranial aneurysms were included. The interobserver reliability was good-to-excellent for individual measurements (intraclass correlation coefficient > 0.70), poor for 2D change (intraclass correlation coefficient < 0.5), and good for 3D change (intraclass correlation coefficient = 0.76). For both 2D and 3D, the reliability was location-dependent and worse for irregularly shaped aneurysms. The smallest detectable changes for 2D height, width, and neck and 3D volume measurements were 1.5 , 2.0, and 1.9 mm and 0.06 mL, respectively. The proportion of growing unruptured intracranial aneurysms decreased from 10% to 2%, depending on the definition of growth (1 mm or the smallest detectable changes for 2D and 3D). CONCLUSIONS: The interobserver reliability of the size measurements of individual 2D and 3D unruptured intracranial aneurysms was good-to-excellent but lower for 2D and 3D growth measurements. For growth assessment, 3D measurements are more reliable than 2D measurements. The smallest detectable change for 2D measurements was larger than 1 mm, the current clinical definition of unruptured intracranial aneurysm growth.
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Keywords: Clinical Neurology, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 0195-6108
Publisher: American Society of Neuroradiology
Note: Funding Information: Received December 22, 2020; accepted after revision March 29, 2021. From the Image Sciences Institute (K.M.T., H.J.K.), Department of Neurology and Neurosurgery (M.D.I.V., Y.M.R.), UMC Utrecht Brain Center, and Department of Radiology (M.J.O., B.K.V., I.C.v.d.S), University Medical Center Utrecht, Utrecht, the Netherlands. We acknowledge the support from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation, CVON2015-08 ERASE, and CVON2018-02 ANEURYSM@RISK. Funding Information: We acknowledge Djenghiz Samlal (D. S.), University Medical Center, Utrecht, the Netherlands, for his contributions. We further acknowledge support from the focus area Applied Data Science, Utrecht University. Publisher Copyright: © 2021 American Society of Neuroradiology. All rights reserved.
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