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01-02-2019

Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease

Authors: Mitchell A. Rees, Jonathan R. Dillman, Christopher G. Anton, Mantosh S. Rattan, Ethan A. Smith, Alexander J. Towbin, Bin Zhang, Andrew T. Trout

Published in: Abdominal Radiology | Issue 2/2019

Abstract

Purpose

To assess inter-radiologist agreement using the Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus recommendations for reporting CT/MR enterography exams in pediatric and young adult small bowel Crohn disease (CD).

Methods

Institutional review board approval was obtained for this HIPAA-compliant retrospective investigation; the requirement for informed consent was waived. 25 CT and 25 MR enterography exams performed in children and young adults (age range: 6–23 years) between January 2015 and April 2017 with a distribution of ileal CD severity (phenotype) were identified: normal or chronic CD without active inflammation (40%), active inflammatory CD (20%), stricturing CD (20%), and penetrating CD (20%). Five fellowship-trained pediatric radiologists, blinded to one another, documented key imaging findings and standardized impressions based on SAR-AGA consensus recommendations. Inter-radiologist agreement was evaluated using Fleiss’ multi-rater kappa statistic (κ) with 95% confidence intervals (CI).

Results

Inter-radiologist agreement was moderate for all key imaging findings except presence of ulcerations (κ 0.37 [95% CI 0.28–0.46]) and sacculations (κ 0.31 [95% CI 0.23–0.40]). Agreement for standardized impressions was substantial for stricturing disease (κ 0.79 [95% CI 0.70–0.87]) and moderate for presence of inflammation (κ 0.49 [95% CI 0.44–0.56]) and penetrating disease (κ 0.58 [95% CI 0.49–0.67]). No significant difference in agreement was found between CT and MRI.

Conclusions

Agreement among five pediatric radiologists was moderate to substantial for SAR-AGA standardized impressions and fair to moderate for key imaging findings of pediatric and young adult CD.

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Title: Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease
Authors: Mitchell A. Rees
Jonathan R. Dillman
Christopher G. Anton
Mantosh S. Rattan
Ethan A. Smith
Alexander J. Towbin
Bin Zhang
Andrew T. Trout
Publication date: 01-02-2019
Publisher: Springer US
Published in: Abdominal Radiology / Issue 2/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-018-1743-5

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