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Published in: Neurological Sciences 4/2024

Open Access 01-11-2023 | Stroke | Original Article

Reliability of the global cortical atrophy visual rating scale applied to computed tomography versus magnetic resonance imaging scans in acute stroke

Authors: Georgina Hobden, Emma Colbourne, Sarah T. Pendlebury, Nele Demeyere

Published in: Neurological Sciences | Issue 4/2024

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Abstract

Introduction

Research using magnetic resonance imaging (MRI) suggests regional cerebral atrophy measures (e.g., frontal lobe, temporal lobe) may predict post-stroke outcomes. Clinical CT scans have excellent potential for use in research but it is unclear whether regional atrophy measures from CT are reliable compared to MRI reference standards.

Methods

We used the Global Cortical Atrophy (GCA) scale to investigate reliability of atrophy measures on CT versus MRI scans from stroke patients originally recruited to the Oxford Cognitive Screening programme. Two raters provided standardised visual ratings at two timepoints. Weighted Kappa statistics assessed the reliability of regional atrophy scores. Spearman’s correlation and a two-way repeated measures ANOVA assessed the reliability of the total score.

Results

On clinically acquired neuroimaging from 98 stroke patients (mean/SD age = 70.97/11.99, 42 female, 84 ischaemic stroke), regional GCA scores on CT versus MRI showed fair to almost perfect intra-rater agreement (κ = .50–.87), substantial to almost perfect intra-rater agreement on CT (κ = .67–.88), and moderate to almost perfect intra-rater reliability on MRI (κ = .50–.89). Regional GCA scores showed mostly moderate to substantial inter-rater reliability on both CT and MRI (κ = .43–.69), except the temporal horns and parieto-occipital region. There was a strong correlation between total GCA scores on CT and MRI (r (96) = .87–.88, p < .001).

Conclusions

These results support the use of cerebral atrophy measures from CT in clinical research, as visual ratings showed generally good agreement between CT and MRI, between raters, and between timepoints.
Literature
1.
go back to reference Ball EL, Sutherland R, Squires C, Mead GE, Religa D, Lundström E, Cheyne J, Wardlaw JM, Quinn TJ, Shenkin SD (2021) Predicting post-stroke cognitive impairment using acute CT neuroimaging: a systematic review and meta-analysis. Int J Stroke, 17474930211045836. https://doi.org/10.1177/17474930211045836 Ball EL, Sutherland R, Squires C, Mead GE, Religa D, Lundström E, Cheyne J, Wardlaw JM, Quinn TJ, Shenkin SD (2021) Predicting post-stroke cognitive impairment using acute CT neuroimaging: a systematic review and meta-analysis. Int J Stroke, 17474930211045836. https://​doi.​org/​10.​1177/​1747493021104583​6
16.
go back to reference Pendlebury ST, Thomson RJ, Welch SJV, Kuker W, Rothwell PM, for the Oxford Vascular Study (2022) Utility of white matter disease and atrophy on routinely acquired brain imaging for prediction of long-term delirium risk: population-based cohort study. Age Ageing 51(1):200. https://doi.org/10.1093/ageing/afab200CrossRef Pendlebury ST, Thomson RJ, Welch SJV, Kuker W, Rothwell PM, for the Oxford Vascular Study (2022) Utility of white matter disease and atrophy on routinely acquired brain imaging for prediction of long-term delirium risk: population-based cohort study. Age Ageing 51(1):200. https://​doi.​org/​10.​1093/​ageing/​afab200CrossRef
17.
go back to reference Sim J, Wright CC (2005) The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 85(3):257–268CrossRefPubMed Sim J, Wright CC (2005) The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 85(3):257–268CrossRefPubMed
20.
go back to reference Weaver NA, Kuijf HJ, Aben HP, Abrigo J, Bae H-J, Barbay M, Best JG, Bordet R, Chappell FM, Chen CPLH, Dondaine T, van der Giessen RS, Godefroy O, Gyanwali B, Hamilton OKL, Hilal S, Huenges Wajer IMC, Kang Y, Kappelle LJ, … Biessels GJ (2021) Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts. Lancet Neurol 20(6):448–459. https://doi.org/10.1016/S1474-4422(21)00060-0 Weaver NA, Kuijf HJ, Aben HP, Abrigo J, Bae H-J, Barbay M, Best JG, Bordet R, Chappell FM, Chen CPLH, Dondaine T, van der Giessen RS, Godefroy O, Gyanwali B, Hamilton OKL, Hilal S, Huenges Wajer IMC, Kang Y, Kappelle LJ, … Biessels GJ (2021) Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts. Lancet Neurol 20(6):448–459. https://​doi.​org/​10.​1016/​S1474-4422(21)00060-0
Metadata
Title
Reliability of the global cortical atrophy visual rating scale applied to computed tomography versus magnetic resonance imaging scans in acute stroke
Authors
Georgina Hobden
Emma Colbourne
Sarah T. Pendlebury
Nele Demeyere
Publication date
01-11-2023
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 4/2024
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-023-07113-z

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