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Interobserver variability in the characterization of giant intracranial aneurysms with special emphasis on aneurysm diameter and shape

  • Clinical Article - Vascular
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Abstract

Background

The Giant Intracranial Aneurysm Registry is a multicenter observational trial exclusively focusing on giant intracranial aneurysms (GIA). As no data exist on the interobserver variability in the radiological description of GIA, there is some uncertainty concerning the reliability of the GIA characteristics included in the registry. We have therefore designed a study to test the interobserver variability in the description of the specific GIA characteristics that are examined in the GIA registry.

Methods

Six different raters analyzed imaging of five GIA concerning GIA location, GIA size, GIA shape, GIA thrombosis, and the presence of perianeurysmal edema. Interobserver variability was examined using intraclass correlation and Fleiss’ kappa analysis.

Results

The intraclass correlation coefficient was 0.99 (95 % CI 0.97–1.0) for the largest GIA diameter and 0.98 (95 % CI 0.94–1.0) for the largest GIA diameter in an axial imaging slice. We found perfect interobserver agreement (Fleiss’ kappa 1.00) in the characterization of GIA location and the presence of perianeurysmal edema and almost perfect interobserver agreement for GIA thrombosis (Fleiss’ kappa 0.86, 95 % CI 0.63–1.00). Only moderate interobserver agreement was found in the description of GIA shape (Fleiss’ kappa 0.50, 95 % CI 0.27–0.73).

Conclusions

While GIA size, location, thrombosis, and the presence of perianeurysmal edema showed excellent interobserver agreement, the description of GIA shape was achieved with only moderate agreement. Data on GIA shape in multicenter studies, like the GIA registry, should therefore be discussed with caution and potentially reassessed in a centralized fashion.

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Acknowledgments

The Giant Intracranial Aneurysm Registry is funded by the Center for Stroke Research – Berlin.

Statement

All trials based on data from the Giant Intracranial Aneurysm Registry were approved by the ethics committees of all participating centers and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All patients included gave their informed consent prior to their inclusion in the study.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Technical University of Munich, Munich, Germany

    Maria Wostrack

  2. Department of Neurosurgery, Georg-August-University Goettingen, Göttingen, Germany

    Dorothee Mielke

  3. Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan

    Naoki Kato

  4. Department of Neurosurgery, University of Greifswald, Greifswald, Germany

    Susanne Guhl

  5. Department of Neurosurgery, University Medical Center, Hamburg Eppendorf, Germany

    Nils Ole Schmidt

  6. Department of Neurosurgery, Charité – Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Nicolai Maldaner, Peter Vajkoczy & Julius Dengler

Authors
  1. Maria Wostrack
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  2. Dorothee Mielke
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  3. Naoki Kato
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  4. Susanne Guhl
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  5. Nils Ole Schmidt
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  6. Nicolai Maldaner
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  7. Peter Vajkoczy
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  8. Julius Dengler
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Consortia

On behalf of the Giant Intracranial Aneurysm Study Group

Corresponding author

Correspondence to Julius Dengler.

Additional information

No parts of this project have been presented anywhere before.

Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT02066493.

Appendix

Appendix

Giant intracranial aneurysm study group members

Vajkoczy P, Maldaner N, Uebelacker A, Dengler J

Department of Neurosurgery, Charité – Universitaetsmedizin Berlin

Endres M

Department of Neurology, Charité – Universitaetsmedizin Berlin

Bohner G, Wiener E, Bauknecht HC

Department of Neuroradiology, Charité – Universitaetsmedizin Berlin

Heuschmann PU, Malzahn U

Institute of Clinical Epidemiology and Biometry, University of Würzburg

Gläsker S, Zentner J, Van Velthoven V

Department of Neurosurgery, University Hospital Freiburg, Germany

Guhl S, Schroeder HWS

Department of Neurosurgery, University of Greifswald, Germany

Strowitzki M

Department of Neurosurgery, Trauma Center Murnau, Murnau, Germany

Etminan N, Haengghi D, Eicker S, Turowski B

Department of Neurosurgery, University of Düsseldorf, Germany

Schebesch KM, Brawanski A

Department of Neurosurgery, University of Regensburg, Germany

Wrede K, Sure U

Department of Neurosurgery, University of Essen, Germany

Schmidt NO, Regelsberger J, Westphal M

Department of Neurosurgery, University Medical Center, Hamburg Eppendorf, Germany

Mielke D, Rohde V

Department of Neurosurgery, Georg-August-University Goettingen, Germany

Hosch H, Moskopp D

Department of Neurosurgery Vivantes-Klinikum im Friedrichshain, Berlin, Germany

Joedicke A

Department of Neurosurgery Vivantes-Klinikum Neukoelln, Berlin, Germany

Hohaus C, Meisel HJ

Department of Neurosurgery, BG-Clinic Bergmannstrost, Halle, Germany.

Wostrack M, Meyer B, Lehmberg J

Department of Neurosurgery, Technical University of Munich, Germany

Musahl C, Hopf N

Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany

Winkler G, Spetzger U

Department of Neurosurgery, Klinikum Karlsruhe, Germany

Graewe A, Meier U

Department of Neurosurgery, Unfallkrankenhaus Berlin, Germany

Hong B, Nakamura M, Krauss J

Department of Neurosurgery, Hannover Medical School, Hannover, Germany

Grote A, Simon M, Schramm J

Department of Neurosurgery, University Hospital Bonn, Bonn, Germany

Kursumovic A, Rath SA

Department of Neurosurgery and Interventional Neuroradiology, Donau-Isar-Klinikum,

Deggendorf, Germany

Marbacher S, Fathi A, Fandino J

Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland,

Familiari P, Raco A

Department of Neurosurgery, University of Rome “Sapienza”, Rome, Italy

BijlengaP, Schaller K

Service de Neurochirurgie, Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland

Gruber A, Wang WT, Knosp E

Department of Neurosurgery, Medical University Vienna, Vienna, Austria

Hoffmann KT, Boxhammer E

Department of Neuroradiology, University of Leipzig, Leipzig, Germany

Rüfenacht DA

Department of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland

Boccardi E, Piano M

Department of Neuroradiology, Ospedale Niguarda Ca’ Granda, Milano, Italy

Niemelä M, Nurminen V, Lehecka M, Hernesniemi J

Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland

Burkhardt JK, Bozinov O, Regli L

Department of Neurosurgery, University Hospital of Zurich, Switzerland

Shekhtman OD, Eliava SS

Burdenko Neurosurgical Institute, Russian Academy of Medical Sciences, Moscow, Russia

N Kato, Irie K, Nishimura K, Kaku S, Arakawa H, Yuki I, Ishibashi T, Murayama Y

Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan

Fiss I, Kombos T

Department of Spine Surgery and Neurosurgery, Helios Klinikum Hildesheim, Hildesheim, Germany

Pedro MT, König R, Wirtz R

Department of Neurosurgery, University Hospital of Ulm, Germany

Helthuis J, van der Zwan A

Department of Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands

Cognard C, Gawlitza M

Department of Neuroradiology, Toulouse University Hospital, Toulouse, France

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Wostrack, M., Mielke, D., Kato, N. et al. Interobserver variability in the characterization of giant intracranial aneurysms with special emphasis on aneurysm diameter and shape. Acta Neurochir 157, 1859–1865 (2015). https://doi.org/10.1007/s00701-015-2587-1

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  • DOI: https://doi.org/10.1007/s00701-015-2587-1

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