Skip Navigation LinksHome > January/February 2011 - Volume 35 - Issue 1 > Interobserver Reliability in the Assessment of Coronary Sten...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3181f80bef
Original Articles

Interobserver Reliability in the Assessment of Coronary Stenoses by Multidetector Computed Tomography

Choudhary, Gaurav MD*†; Atalay, Michael K. MD, PhD†‡; Ritter, Nathan MD*†; Shin, Victor MD*†; Grand, David MD†‡; Pearson, Catherine AB†; Kirchner, Robert Michael MD*†; Wu, Wen-Chih MD*†

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Objective: To determine the interobserver reliability for grading coronary stenosis severity with coronary computed tomographic angiography (CCTA).

Methods: Five readers independently reviewed 40 CCTA studies, first the axial images alone, then in combination with multiplanar reconstructions. The stenosis severity in each segment was scored on a 5-point scale. Intraclass correlation (ICC) analysis was performed to assess interobserver reliability on a segmental basis.

Results: The reliability was good to moderate in the right coronary artery, left main artery, left anterior descending artery and branches, and the proximal circumflex (ICC: 0.44-0.75) but fair to poor for the posterior descending artery, the posterolateral branch, the obtuse marginal branches, and the distal circumflex (ICC: 0.15-0.39). The ICC correlated with the reference diameter. Although there was no significant difference in the ICC between the scanner types, there were more unevaluable segments in the 16-row scanner compared with the 64-row scanner (2.4 vs 1.4 segments/patient). Addition of multiplanar reconstruction to axial images led to fewer uninterpretable segments and reclassification of stenosis grade in 23% of the segments.

Conclusions: Interobserver reliability for stenosis severity by CCTA varies between segments and correlates with the reference diameter.

© 2011 Lippincott Williams & Wilkins, Inc.



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