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Subjective Analysis of the Filling of an Acetabular Osteolytic Lesion Following Percutaneous Cementoplasty: Is It Reliable?

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To study the interobserver agreement for the analysis of lesion filling following cementoplasty of an acetabular osteolytic lesion, and investigate how subjective analysis compares to volumetric analysis.

Materials and methods

A total of 21 acetabular osteolysis were retrospectively analysed on pre- and immediate post-cementoplasty CT-scans by two senior interventional radiologists and one resident using a 4 grade scale to quantify lesion filling (Fsubjective): F ≤ 25%, 25% < F ≤ 50%, 50% < F ≤ 75% or F > 75%. Volumetric analysis (Fvolumetric) was performed with the delineation of the osteolysis and the cement using regions of interest. The interobserver agreement for Fsubjective was evaluated using the Fleiss’ Kappa test for the 4 grade scale and for a simplified 2 grades scale (F ≤ 50% and F > 50%). The performance of Fsubjective versus Fvolumetric (considered as the gold standard) was then evaluated for each reader using the calculation of accuracy and error to reference for the 4 grades scale and accuracy, sensitivity, specificity, positive predictive value and negative predictive value for the 2 grade scale.

Results

Interobserver agreement was considered as very low (< 0.2) for the 4 grade scale analysis and as low (> 0.2 and < 0.4) for the 2 grade scales analysis with kappa factors of 0.196 and 0.36 respectively. Compared to volumetric analysis, the overall accuracy of the 4- and 2- grade scales were 36.5% and 60% respectively.

Conclusion

Subjective evaluation of cement filling of an acetabular osteolytic lesion is associated with poor interobserver agreement and overestimation of the percentage compared to volumetric analysis.

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Authors and Affiliations

  1. Department of Interventional Radiology, Nouvel Hôpital Civil, 1, Place de l’hôpital, 67096, Strasbourg Cedex, France

    Julien Garnon, Pierre De Marini, Pierre Auloge, Theo Mayer, Roberto Luigi Cazzato & Afshin Gangi

  2. ICube - University of Strasbourg, UMR 7357, CNRS, INSA Strasbourg, 1 Place de l’hôpital, 67091, Strasbourg, France

    Julien Garnon, Laurence Meylheuc & Bernard Bayle

  3. Department of Radiology, Kings College London, NHS Foundation Trust, London, UK

    Danoob Dalili

Authors
  1. Julien Garnon
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  2. Laurence Meylheuc
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  3. Pierre De Marini
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  4. Pierre Auloge
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  5. Theo Mayer
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  6. Danoob Dalili
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  7. Roberto Luigi Cazzato
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  9. Afshin Gangi
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Correspondence to Julien Garnon.

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Informed consent was obtained from all individual participants included in the study.

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Garnon, J., Meylheuc, L., De Marini, P. et al. Subjective Analysis of the Filling of an Acetabular Osteolytic Lesion Following Percutaneous Cementoplasty: Is It Reliable?. Cardiovasc Intervent Radiol 43, 445–452 (2020). https://doi.org/10.1007/s00270-019-02397-1

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  • DOI: https://doi.org/10.1007/s00270-019-02397-1

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