We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Inter-rater agreement between humans and computer in quantitative assessment of computed tomography after cardiac arrest.
- Authors
Kenda, Martin; Zhuo Cheng; Guettler, Christopher; Storm, Christian; Ploner, Christoph J.; Leithner, Christoph; Scheel, Michael
- Abstract
Background:Head computed tomography (CT) is used to predict neurological outcome after cardiac arrest (CA). The current reference standard includes quantitative image analysis by a neuroradiologist to determine the Gray-White-Matter Ratio (GWR) which is calculated via the manual measurement of radiodensity in different brain regions. Recently, automated analysis methods have been introduced. There is limited data on the Inter-rater agreement of both methods. Methods: Three blinded human raters (neuroradiologist, neurologist, student) with different levels of clinical experience retrospectively assessed the Gray-White-Matter Ratio (GWR) in head CTs of 95 CA patients. GWR was also quantified by a recently published computer algorithmthat uses coregistration with standardized brain spaces to identify regions of interest (ROIs). We calculated intraclass correlation (ICC) for inter-rater agreement between human and computer raters as well as area under the curve (AUC) and sensitivity/specificity for poor outcome prognostication. Results: Inter-rater agreement on GWR was very good (ICC 0.82-0.84) between all three human raters across different levels of expertise and between the computer algorithm and neuroradiologist (ICC 0.83; 95% CI 0.78-0.88). Despite high overall agreement, we observed considerable, clinically relevant deviations of GWR measurements (up to 0.24) in individual patients. In our cohort, at a GWR threshold of 1.10, this did not lead to any false poor neurological outcome prediction. Conclusion: Human and computer raters demonstrated high overall agreement in GWR determination in head CTs after CA. The clinically relevant deviations of GWR measurement in individual patients underscore the necessity of additional qualitative evaluation and integration of head CT findings into a multimodal approach to prognostication of neurological outcome after CA.
- Subjects
CARDIAC arrest; COMPUTED tomography; IMAGE analysis; COMPUTER algorithms; INTRACLASS correlation; SYSTEMATIZED Nomenclature of Medicine
- Publication
Frontiers in Neurology, 2022, Vol 13, p1
- ISSN
1664-2295
- Publication type
Article
- DOI
10.3389/fneur.2022.990208