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Metastatic versus osteoporotic vertebral fractures on MRI: a blinded, multicenter and multispecialty observer agreement evaluation

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Metastatic versus osteoporotic vertebral fractures on MRI: a blinded, multicenter and multispecialty observer agreement evaluation

dc.contributor.author	Arana, Estanislao
dc.contributor.author	Kovacs, Francisco M.
dc.contributor.author	Royuela, Ana
dc.contributor.author	Asenjo, Beatriz
dc.contributor.author	Nagib, Fatima
dc.contributor.author	Pérez-Aguilera, Sandra
dc.contributor.author	Dejoz, Maria
dc.contributor.author	Cabrera-Zubizarreta, Alberto
dc.contributor.author	García-Hidalgo, Yolanda
dc.contributor.author	Estremera, Ana
dc.contributor.author	Vanaclocha Vanaclocha, Vicente
dc.contributor.author	Spanish Back Pain Research Network Task Force for
dc.date.accessioned	2023-03-27T08:00:37Z
dc.date.available	2023-03-27T08:00:37Z
dc.date.issued	2020
dc.identifier.citation	Arana, Estanislao Kovacs, Francisco M. Royuela, Ana Asenjo, Beatriz Nagib, Fatima Pérez-Aguilera, Sandra Dejoz, Maria Cabrera-Zubizarreta, Alberto García-Hidalgo, Yolanda Estremera, Ana Vanaclocha Vanaclocha, Vicente Spanish Back Pain Research Network Task Force for 2020 Metastatic versus osteoporotic vertebral fractures on MRI: a blinded, multicenter and multispecialty observer agreement evaluation Journal Of The National Comprehensive Cancer Network 18 3 267 273
dc.identifier.uri	https://hdl.handle.net/10550/85927
dc.description.abstract	Background: MRI is assumed to be valid for distinguishing metastatic vertebral fractures (MVFs) from osteoporotic vertebral fractures (OVFs). This study assessed (1) concordance between the imagebased diagnosis of MVF versus OVF and the reference (biopsy or follow-up of .6 months), (2) interobserver and intraobserver agreement on key imaging findings and the diagnosis of MVF versus OVF, and (3) whether disclosing a patient's history of cancer leads to variations in diagnosis, concordance, or agreement. Patients and Methods: This retrospective cohort study included clinical data and imaging from 203 patients with confirmed MVF or OVF provided to 25 clinicians (neurosurgeons, radiologists, orthopedic surgeons, and radiation oncologists). From January 2018 through October 2018, the clinicians interpreted images in conditions as close as possible to routine practice. Each specialist assessed data twice, with minimum 6-week interval, blinded to assessments made by other clinicians and to their own previous assessments. The kappa statistic was used to assess interobserver and intraobserver agreement on key imaging findings, diagnosis (MVF vs OVF), and concordance with the reference. Subgroup analyses were based on clinicians' specialty, years of experience, and complexity of the hospital where they worked. Results: For diagnosis of MVF versus OVF, interobserver agreement was fair, whereas intraobserver agreement was substantial. Only the latter improved to almost perfect when a patient's history of cancer was disclosed. Interobserver agreement for key imaging findings was fair or moderate, whereas intraobserver agreement on key imaging findings was moderate or substantial. Concordance between the diagnosis of MVF versus OVF and the reference was moderate. Results were similar regardless of clinicians' specialty, experience, and hospital category. Conclusions: When MRI is used to distinguish MVF versus OVF, interobserver agreement and concordance with the reference were moderate. These results cast doubt on the reliability of basing such a diagnosis on MRI in routine practice.
dc.language.iso	eng
dc.relation.ispartof	Journal Of The National Comprehensive Cancer Network, 2020, vol. 18, num. 3, p. 267-273
dc.subject	Càncer
dc.subject	Ossos
dc.title	Metastatic versus osteoporotic vertebral fractures on MRI: a blinded, multicenter and multispecialty observer agreement evaluation
dc.type	journal article	es_ES
dc.date.updated	2023-03-27T08:00:37Z
dc.identifier.doi	10.6004/jnccn.2019.7367
dc.identifier.idgrec	149272
dc.rights.accessRights	open access	es_ES