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European Radiology

, Volume 17, Issue 1, pp 67–71 | Cite as

Interobserver agreement on the radiological criteria of the International Panel on the diagnosis of multiple sclerosis

  • Tijmen KortewegEmail author
  • Bernard M. J. Uitdehaag
  • Dirk L. Knol
  • Robin H. M. Smithuis
  • Paul R. Algra
  • Cees de Vries
  • Peter A. Poppe
  • Jan-Hein T. M. van Waesberghe
  • Elisabeth Bergers
  • Geert J. Lycklama à Nijeholt
  • Chris H. Polman
  • Frederik Barkhof
Neuro

Abstract

We assessed the interobserver agreement on the radiological part of the International Panel (IP) criteria for the diagnosis of multiple sclerosis (MS), comprising the assessment of dissemination in space (DIS) and time (DIT) based exclusively on MRI. Four radiologists trained and four radiologists naive in the application of the IP criteria scored the fulfillment for DIS (i.e., ≥3 periventricular, ≥1 infratentorial, ≥1 juxtacortical, ≥ 1 enhancing lesion or a total of ≥9 T2-weighted lesions) and DIT (presence of new or enhancing lesions at follow-up) in baseline and two follow-up scans from 20 patients suspected for having MS. The IP-trained radiologists agreed at least moderately on all assessments (κ>0.40), whereas the IP-naive radiologists showed fair agreement (κ<0.40) on five of 16 assessments. In the final conclusion on DIS and DIT, the IP-trained radiologists agreed substantially on both items (κ=0.62 and κ=0.60, respectively) compared with a fair agreement on DIS (κ=0.29) and moderate agreement on DIT (κ=0.52) among the IP-naive radiologists. Given the poor interobserver agreement among IP-naive observers, the new IP criteria for MS require additional training and should perhaps be simplified.

Keywords

MRI Diagnosis Brain Multiple sclerosis 

Notes

Acknowledgements

The VU University Center for MS Research is supported by the Dutch MSResearch Foundation (Voorschoten, The Netherlands). Further, the DutchMS Research Foundation (Voorschoten, The Netherlands) also supportsT.Korteweg (grant 00–425 MS).

References

  1. 1.
    Poser CM, Paty DW, Scheinberg L et al (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231PubMedCrossRefGoogle Scholar
  2. 2.
    McDonald WI, Compston A, Edan G et al (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 50:121–127PubMedCrossRefGoogle Scholar
  3. 3.
    Barkhof F, Filippi M, Miller DH et al (1997) Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain 120(Pt 11):2059–2069PubMedCrossRefGoogle Scholar
  4. 4.
    Tintore M, Rovira A, Martinez MJ et al (2000) Isolated demyelinating syndromes: comparison of different MR imaging criteria to predict conversion to clinically definite multiple sclerosis. AJNR Am J Neuroradiol 21:702–706PubMedGoogle Scholar
  5. 5.
    Dalton CM, Brex PA, Miszkiel KA et al (2002) Application of the new McDonald criteria to patients with clinically isolated syndromes suggestive of multiple sclerosis. Ann Neurol 52:47–53PubMedCrossRefGoogle Scholar
  6. 6.
    CHAMPS Study Group (2002) Baseline MRI characteristics of patients at high risk for multiple sclerosis: results from the CHAMPS trial. Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study. Mult Scler 8:330–338CrossRefGoogle Scholar
  7. 7.
    CHAMPS Study Group (2002) MRI predictors of early conversion to clinically definite MS in the CHAMPS placebo group. Neurology 59:998–1005Google Scholar
  8. 8.
    Tintore M, Rovira A, Rio J et al (2003) New diagnostic criteria for multiple sclerosis: application in first demyelinating episode. Neurology 60:27–30PubMedCrossRefGoogle Scholar
  9. 9.
    Barkhof F, Filippi M, van Waesberghe JH, Campi A, Miller DH, Ader HJ (1999) Interobserver agreement for diagnostic MRI criteria in suspected multiple sclerosis. Neuroradiology 41:347–350PubMedCrossRefGoogle Scholar
  10. 10.
    Zipoli V, Portaccio E, Siracusa G, Pracucci G, Sorbi S, Amato MP (2003) Interobserver agreement on Poser’s and the new McDonald’s diagnostic criteria for multiple sclerosis. Mult Scler 9:481–485PubMedCrossRefGoogle Scholar
  11. 11.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRefGoogle Scholar
  12. 12.
    Altman DG (1991) Practical statistics for medical research. Chapman and Hall, LondonGoogle Scholar
  13. 13.
    Popping R (1999) AGREE 7.2. ProGAMMA, GroningenGoogle Scholar
  14. 14.
    Paty DW, Oger JJ, Kastrukoff LF et al (1988) MRI in the diagnosis of MS: a prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT. Neurology 38:180–185PubMedGoogle Scholar
  15. 15.
    Molyneux PD, Miller DH, Filippi M et al (1999) Visual analysis of serial T2-weighted MRI in multiple sclerosis: intra- and interobserver reproducibility. Neuroradiology 41:882–888PubMedCrossRefGoogle Scholar
  16. 16.
    Rovaris M, Barkhof F, Bastianello S et al (1999) Multiple sclerosis: interobserver agreement in reporting active lesions on serial brain MRI using conventional spin echo, fast spin echo, fast fluid-attenuated inversion recovery and post-contrast T1-weighted images. J Neurol 246:920–925PubMedCrossRefGoogle Scholar
  17. 17.
    Filippi M, Gawne-Cain ML, Gasperini C et al (1998) Effect of training and different measurement strategies on the reproducibility of brain MRI lesion load measurements in multiple sclerosis. Neurology 50:238–244PubMedGoogle Scholar
  18. 18.
    Dalton CM, Brex PA, Miszkiel KA et al (2003) New T2 lesions enable an earlier diagnosis of multiple sclerosis in clinically isolated syndromes. Ann Neurol 53:673–676PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Tijmen Korteweg
    • 1
    Email author
  • Bernard M. J. Uitdehaag
    • 2
    • 3
  • Dirk L. Knol
    • 3
  • Robin H. M. Smithuis
    • 4
  • Paul R. Algra
    • 5
  • Cees de Vries
    • 6
  • Peter A. Poppe
    • 1
  • Jan-Hein T. M. van Waesberghe
    • 1
  • Elisabeth Bergers
    • 1
  • Geert J. Lycklama à Nijeholt
    • 1
  • Chris H. Polman
    • 2
  • Frederik Barkhof
    • 1
  1. 1.Department of RadiologyVU University Medical CentreAmsterdamThe Netherlands
  2. 2.Department of NeurologyVU University Medical CentreAmsterdamThe Netherlands
  3. 3.Department of Clinical Epidemiology and BiostatisticsVU University Medical CentreAmsterdamThe Netherlands
  4. 4.Department of RadiologyRijnland HospitalLeiderdorpThe Netherlands
  5. 5.Department of RadiologyMedical Centre AlkmaarAlkmaarThe Netherlands
  6. 6.Department of RadiologyOLVGAmsterdamThe Netherlands

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