Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 1/2017

Open Access 01-01-2017 | Chest

Diagnosis of diffuse idiopathic skeletal hyperostosis with chest computed tomography: inter-observer agreement

Authors: S. F. Oudkerk, Pim A. de Jong, M. Attrach, T. Luijkx, C. F. Buckens, W. P. Th. M. Mali, F. C. Oner, D. L. Resnick, R. Vliegenthart, J. J. Verlaan

Published in: European Radiology | Issue 1/2017

Login to get access

Abstract

Objective

To evaluate and improve the interobserver agreement for the CT-based diagnosis of diffuse idiopathic skeletal hyperostosis (DISH).

Methods

Six hundred participants of the CT arm of a lung cancer screening trial were randomly divided into two groups. The first 300 CTs were scored by five observers for the presence of DISH based on the original Resnick criteria for radiographs. After analysis of the data a consensus meeting was organised and the criteria were slightly modified regarding the definition of ‘contiguous’, the definition of ‘flowing ossifications’ and the viewing plane and window level. Subsequently, the second set of 300 CTs was scored by the same observers. κ ≥ 0.61 was considered good agreement.

Results

The 600 male participants were on average 63.5 (SD 5.3) years old and had smoked on average 38.0 pack-years. In the first round κ values ranged from 0.32 to 0.74 and 7 out of 10 values were below 0.61. After the consensus meeting the interobserver agreement ranged from 0.51 to 0.86 and 3 out of 10 values were below 0.61. The agreement improved significantly.

Conclusions

This is the first study that reports interobserver agreement for the diagnosis of DISH on chest CT, showing mostly good agreement for modified Resnick criteria.

Key Points

• DISH is diagnosed on fluoroscopic and radiographic examinations using Resnick criteria
• Evaluation of DISH on chest CT was modestly reproducible with the Resnick criteria
• A consensus meeting and Resnick criteria modification improved inter-rater reliability for DISH
• Reproducible CT criteria for DISH aids research into this poorly understood entity
Literature
1.
Miyazawa N, Akiyama I et al (2007) Ossification of the ligamentum flavum of the cervical spine. J Neurosurg Sci 51:139–44PubMed
2.
Julkunen H, Heinonen OP, Knekt P (1975) The epidemiology of hyperostosis of the spine together with its symptoms and related mortality in a general population. Scand J Rheumatol 4:23–7CrossRefPubMed
3.
Kim SK, Choi BR, Kim CG et al (2004) The prevalence of diffuse idiopathic skeletal hyperostosis in Korea. J Rheumatol 31:2032–5PubMed
4.
Westerveld LA, Verlaan JJ et al (2009) Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications. Eur Spine J 18:145–56CrossRefPubMed
5.
Resnick D, Niwayama G (1976) Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology 119:559–68CrossRefPubMed
6.
Rogers J, Waldron T et al (2001) DISH and the monastic way of life. Int J Osteoarchaeol 11:357–65CrossRef
7.
Utsinger PD et al (1985) Diffuse idiopathic skeletal hyperostosis. Clin Rheum Dis 11:325–51PubMed
8.
Littlejohn G et al (1985) Insulin and new bone formation in diffuse idiopathic skeletal hyperostosis. Clin Rheumatol 4:294–300CrossRefPubMed
9.
Vezyroglou G, Mitropoulos A, Kyriazis N et al (1996) A metabolic syndrome in diffuse idiopathic skeletal hyperostosis: a controlled study. J Rheumatol 23:672–6PubMed
10.
Laroche M, Moulinier L, Arlet J et al (1992) Lumbar and cervical stenosis. Frequency of the association, role of the ankylosing hyperostosis. Clin Rheumatol 11:533–5CrossRefPubMed
11.
Sarzi-Puttini AF (2004) New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis). Curr Opin Rheumatol 16:287–92CrossRefPubMed
12.
13.
Mader R et al (2013) Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms. Nat Rev Rheumatol 9:741–50CrossRefPubMed
14.
Westerveld et al (2008) The prevalence of diffuse idiopathic skeletal hyperostosis in an outpatient population in the Netherlands. J Rheumatol 35:1635–8PubMed
15.
Westerveld LA et al (2014) Clinical outcome after traumatic spinal fractures in patients with ankylosing spinal disorders compared with control patients. Spine J 14:729–40CrossRefPubMed
16.
van Iersel CA, de Koning HJ, Draisma G, Mali WP, Scholten ET et al (2007) Risk-based selection from the general population in a screening trial: selection criteria, recruitment and power for the Dutch-Belgian randomised lung cancer multi-slice CT screening trial (NELSON). Int J Cancer 120:868–74CrossRefPubMed
17.
ten Cate O, Snell L, Carraccio C (2010) Medical competence: the interplay between individual ability and the health care environment. Med Teach 32:669–75CrossRefPubMed
18.
19.
20.
Yoshida M, Kibe A, Aizawa H et al (1999) Diffuse idiopathic skeletal hyperostosis with fibrobullous change in upper lung lobes and dyspnea due to limitation of thoracic cage. Nihon Kokyuki Gakkai Zasshi 37:823–8PubMed
21.
Mata S et al (1998) Comprehensive radiographic evaluation of diffuse idiopathic skeletal hyperostosis: development and interrater reliability of a scoring system. Semin Arthritis Rheum 28:88–96CrossRefPubMed
Metadata
Title
Diagnosis of diffuse idiopathic skeletal hyperostosis with chest computed tomography: inter-observer agreement
Authors
S. F. Oudkerk
Pim A. de Jong
M. Attrach
T. Luijkx
C. F. Buckens
W. P. Th. M. Mali
F. C. Oner
D. L. Resnick
R. Vliegenthart
J. J. Verlaan
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4355-x

Other articles of this Issue 1/2017

European Radiology 1/2017 Go to the issue

Interventional

Incidence and management of oesophageal ruptures following fluoroscopic balloon dilatation in children with benign strictures

Hepatobiliary-Pancreas

Combined gadoxetic acid and gadofosveset enhanced liver MRI for detection and characterization of liver metastases

Oncology

Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer

Musculoskeletal

Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year

Cardiac

Sequential SPECT/CT imaging starting with stress SPECT in patients with left bundle branch block suspected for coronary artery disease

Magnetic Resonance

Repeatability of derived parameters from histograms following non-Gaussian diffusion modelling of diffusion-weighted imaging in a paediatric oncological cohort