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01.07.2014 | Cardiac

Cardiac valve calcifications on low-dose unenhanced ungated chest computed tomography: inter-observer and inter-examination reliability, agreement and variability

verfasst von: Robbert W. van Hamersvelt, Martin J. Willemink, Richard A. P. Takx, Anouk L. M. Eikendal, Ricardo P. J. Budde, Tim Leiner, Christian P. Mol, Ivana Isgum, Pim A. de Jong

Erschienen in: European Radiology | Ausgabe 7/2014

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Abstract

Objectives

To determine inter-observer and inter-examination variability for aortic valve calcification (AVC) and mitral valve and annulus calcification (MC) in low-dose unenhanced ungated lung cancer screening chest computed tomography (CT).

Methods

We included 578 lung cancer screening trial participants who were examined by CT twice within 3 months to follow indeterminate pulmonary nodules. On these CTs, AVC and MC were measured in cubic millimetres. One hundred CTs were examined by five observers to determine the inter-observer variability. Reliability was assessed by kappa statistics (κ) and intra-class correlation coefficients (ICCs). Variability was expressed as the mean difference ± standard deviation (SD).

Results

Inter-examination reliability was excellent for AVC (κ = 0.94, ICC = 0.96) and MC (κ = 0.95, ICC = 0.90). Inter-examination variability was 12.7 ± 118.2 mm³ for AVC and 31.5 ± 219.2 mm³ for MC. Inter-observer reliability ranged from κ = 0.68 to κ = 0.92 for AVC and from κ = 0.20 to κ = 0.66 for MC. Inter-observer ICC was 0.94 for AVC and ranged from 0.56 to 0.97 for MC. Inter-observer variability ranged from -30.5 ± 252.0 mm³ to 84.0 ± 240.5 mm³ for AVC and from -95.2 ± 210.0 mm³ to 303.7 ± 501.6 mm³ for MC.

Conclusions

AVC can be quantified with excellent reliability on ungated unenhanced low-dose chest CT, but manual detection of MC can be subject to substantial inter-observer variability. Lung cancer screening CT may be used for detection and quantification of cardiac valve calcifications.

Key points

• Low-dose unenhanced ungated chest computed tomography can detect cardiac valve calcifications.

• However, calcified cardiac valves are not reported by most radiologists.

• Inter-observer and inter-examination variability of aortic valve calcifications is sufficient for longitudinal studies.

• Volumetric measurement variability of mitral valve and annulus calcifications is substantial.

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Titel: Cardiac valve calcifications on low-dose unenhanced ungated chest computed tomography: inter-observer and inter-examination reliability, agreement and variability
verfasst von: Robbert W. van Hamersvelt
Martin J. Willemink
Richard A. P. Takx
Anouk L. M. Eikendal
Ricardo P. J. Budde
Tim Leiner
Christian P. Mol
Ivana Isgum
Pim A. de Jong
Publikationsdatum: 01.07.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 7/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3191-0

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Cardiac valve calcifications on low-dose unenhanced ungated chest computed tomography: inter-observer and inter-examination reliability, agreement and variability