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Poor inter-observer...
Poor inter-observer agreement in anatomical classifications of infrapopliteal arterial disease due to mandatory selection of only one target artery
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- Ludwigs, Karin (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Halmstad County Hospital,Univ Gothenburg, Sweden; Hallands Hosp, Sweden
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- Andersson, Manne (author)
- Linköpings universitet,Linköping University,Ryhov County Hospital, Jönköping,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Ryhov Cty Hosp, Sweden
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- Johnsson, Åse (Allansdotter), 1966 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Sahlgrenska University Hospital,Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
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- Nordanstig, Joakim (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska University Hospital,Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
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- Svalkvist, Angelica (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences,Sahlgrenska Academy,Sahlgrenska University Hospital,Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden
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- Falkenberg, Mårten, 1959 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Sahlgrenska University Hospital,Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
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- Baubeta, Erik (author)
- Lund University,Lunds universitet,Diagnostisk radiologi, Malmö,Forskargrupper vid Lunds universitet,Radiology Diagnostics, Malmö,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden
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(creator_code:org_t)
- 2022-05-26
- 2023
- English.
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In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 64:3, s. 1298-1306
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Abstract
Subject headings
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- Background Established anatomical classifications of infrapopliteal arterial lesion severity are based on assessment of only one target artery, not including all infrapopliteal arteries although multivessel revascularization is common. Purpose To investigate the reproducibility of one of these classifications and a new aggregated score. Material and Methods A total of 68 patients undergoing endovascular infrapopliteal revascularization at Sahlgrenska University Hospital during 2008-2016 were included. Preoperative magnetic resonance angiographies (MRA) and digital subtraction angiographies (DSA) were evaluated by three blinded observers in random order, using the infrapopliteal TransAtlantic Inter-Society Consensus (TASC) II classification. An aggregated score, the Infrapopliteal Total Atherosclerotic Burden (I-TAB) score, including all infrapopliteal arteries, was constructed and used for comparison. Results Inter-observer agreement on lesion severity for each evaluated artery was good; Krippendorff's alpha for MRA 0.64-0.79 and DSA 0.66-0.84. Inter-observer agreement on TASC II grade, based on the selected target artery as stipulated, was poor; Krippendorff's alpha 0.14 (95% confidence interval [CI]=-0.05 to 0.30) for MRA and 0.48 (95% CI=0.33-0.61) for DSA. Inter-observer agreement for the new I-TAB score was good; Krippendorff's alpha 0.76 (95% CI=0.70-0.81) for MRA and 0.79 (95% CI=0.74-0.84) for DSA. Conclusion Reproducible assessment of infrapopliteal lesion severity can be achieved for separate arteries with both MRA and DSA using the TASC II definitions. However, poor inter-observer agreement in selecting the target artery results in low reproducibility of the overall infrapopliteal TASC II grade. An aggregated score, such as I-TAB, results in less variability and may provide a more robust evaluation tool of atherosclerotic disease severity.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Peripheral arterial disease
- endovascular procedures
- magnetic resonance
- angiography
- digital subtraction angiography
- anatomical classification
- infrapopliteal
- critical limb ischemia
- management
- update
- Radiology
- Nuclear Medicine & Medical Imaging
- Peripheral arterial disease; endovascular procedures; magnetic resonance angiography; digital subtraction angiography; anatomical classification; infrapopliteal
Publication and Content Type
- ref (subject category)
- art (subject category)
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