Cardiac function by MRI in congenital heart disease: Impact of consensus training on interinstitutional variance
✍ Scribed by Philipp Beerbaum; Peter Barth; Siegfried Kropf; Samir Sarikouch; Andrea Kelter-Kloepping; Diana Franke; Matthias Gutberlet; Titus Kuehne
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 284 KB
- Volume
- 30
- Category
- Article
- ISSN
- 1053-1807
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Purpose:
To investigate the impact of interinstitutional variance (=interobserver variance between institutions) for volumetric and flow cardiac MR (CMR) data and if training on image reading could improve bias.
Materials and Methods:
In a three‐center study, a total of 32 adults with repaired Tetralogy of Fallot and 23 controls underwent CMR using standardized protocols for ventricular volumes/mass (by transverse and short‐axis cine‐MRI) and pulmonary/aortic blood flow by velocity‐encoded MRI (VEC‐MRI). Data were analyzed blinded and independently in each institution by experienced readers. Interinstitutional variance was determined before/after training on consented guidelines for image analysis.
Results:
In patients, initial interinstitutional variability of right ventricular parameters was substantial but decreased by training. On transverse planes, variation coefficient for end‐diastolic/systolic volumes and ejection fraction decreased from 22%, 19%, and 19% to 7%, 10%, and 8%, respectively (P < 0.025). Left‐ventricular variation coefficients improved for end‐diastolic and stroke volumes from 8% and 15% to 4% and 6%, respectively (P < 0.007). For short‐axis volumetry training resulted in narrowed limits of confidence. Variability did not significantly change in the controls. There was no significant difference between transverse/short‐axis MRI. Interinstitutional variance for VEC‐MRI in patients/controls was low (<4%).
Conclusion:
Interinstitutional variance is an important source of variability in volumetric but not in flow CMR. Such variance can be reduced effectively by consented training. J. Magn. Reson. Imaging 2009;30:956–966. © 2009 Wiley‐Liss, Inc.