PMID- 25385747
OWN - NLM
STAT- MEDLINE
DCOM- 20160929
LR  - 20161126
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Linking)
VI  - 8
IP  - 1
DP  - 2016 Jan
TI  - Interobserver variability of aneurysm morphology: discrimination of the daughter 
      sac.
PG  - 38-41
LID - 10.1136/neurintsurg-2014-011471 [doi]
AB  - OBJECTIVE: Several definitions have been proposed to distinguish the daughter sac 
      when treating unruptured intracranial aneurysms. The aim of this study was to 
      evaluate interobserver variability of aneurysm morphology, including the daughter 
      sac, using criteria from the International Study of Unruptured Intracranial 
      Aneurysms (ISUIA) and the Unruptured Cerebral Aneurysm Study of Japan (UCAS). 
      MATERIALS AND METHODS: After approval by the institutional review board, we 
      analyzed three morphological features (daughter sac, lobulation, and irregular 
      margin) from the ISUIA and UCAS using angiographic images from 102 saccular 
      aneurysms. Four independent readers interpreted each morphological criterion 
      using dichotomized scales (existence or not). The kappa statistic was used to measure 
      interobserver agreement, and kappa>0.6 was considered substantial agreement. RESULTS: 
      For discrimination of the daughter sac, interobserver agreement among the four 
      readers was substantial using the UCAS criteria (k=0.626 for two-dimensional (2D) 
      and 0.659 for three-dimensional (3D) images) but not for the ISUIA criteria 
      (k=0.487 for 2D and 0.473 for 3D images; significant difference). Irrespective of 
      the images used, pairwise pooled kappa values for the UCAS were >0.6, except for one 
      case (score of 0.54 between readers A and B). Regarding the proportion of 
      positive reads, there was a significant difference between reads for the daughter 
      sac using the UCAS and ISUIA criteria. CONCLUSIONS: For discrimination of the 
      daughter sac, the UCAS definition showed a higher reliability than the ISUIA. 
      However, a further prospective study is necessary to validate this definition as 
      the treatment standard for unruptured intracranial aneurysms.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/
FAU - Suh, Sang Hyun
AU  - Suh SH
AD  - Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, 
      Korea.
FAU - Cloft, Harry J
AU  - Cloft HJ
AD  - Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Huston, John 3rd
AU  - Huston J 3rd
AD  - Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Han, Kyung Hwa
AU  - Han KH
AD  - Biostatistics Collaboration Unit, Gangnam Medical Research Center, Yonsei 
      University College of Medicine, Seoul, Korea.
FAU - Kallmes, David F
AU  - Kallmes DF
AD  - Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141110
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiography, Digital Subtraction/methods/standards
MH  - Cerebral Angiography/*methods/*standards
MH  - Female
MH  - Humans
MH  - Imaging, Three-Dimensional/methods/standards
MH  - Intracranial Aneurysm/*diagnosis/diagnostic imaging/pathology
MH  - Magnetic Resonance Angiography/methods/standards
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Reproducibility of Results
OTO - NOTNLM
OT  - Aneurysm
OT  - Angiography
EDAT- 2014/11/12 06:00
MHDA- 2016/09/30 06:00
CRDT- 2014/11/12 06:00
PHST- 2014/09/18 00:00 [received]
PHST- 2014/10/23 00:00 [accepted]
PHST- 2014/11/12 06:00 [entrez]
PHST- 2014/11/12 06:00 [pubmed]
PHST- 2016/09/30 06:00 [medline]
AID - neurintsurg-2014-011471 [pii]
AID - 10.1136/neurintsurg-2014-011471 [doi]
PST - ppublish
SO  - J Neurointerv Surg. 2016 Jan;8(1):38-41. doi: 10.1136/neurintsurg-2014-011471. 
      Epub 2014 Nov 10.