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Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease

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Abstract

Purpose

To assess inter-radiologist agreement using the Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus recommendations for reporting CT/MR enterography exams in pediatric and young adult small bowel Crohn disease (CD).

Methods

Institutional review board approval was obtained for this HIPAA-compliant retrospective investigation; the requirement for informed consent was waived. 25 CT and 25 MR enterography exams performed in children and young adults (age range: 6–23 years) between January 2015 and April 2017 with a distribution of ileal CD severity (phenotype) were identified: normal or chronic CD without active inflammation (40%), active inflammatory CD (20%), stricturing CD (20%), and penetrating CD (20%). Five fellowship-trained pediatric radiologists, blinded to one another, documented key imaging findings and standardized impressions based on SAR-AGA consensus recommendations. Inter-radiologist agreement was evaluated using Fleiss’ multi-rater kappa statistic (κ) with 95% confidence intervals (CI).

Results

Inter-radiologist agreement was moderate for all key imaging findings except presence of ulcerations (κ 0.37 [95% CI 0.28–0.46]) and sacculations (κ 0.31 [95% CI 0.23–0.40]). Agreement for standardized impressions was substantial for stricturing disease (κ 0.79 [95% CI 0.70–0.87]) and moderate for presence of inflammation (κ 0.49 [95% CI 0.44–0.56]) and penetrating disease (κ 0.58 [95% CI 0.49–0.67]). No significant difference in agreement was found between CT and MRI.

Conclusions

Agreement among five pediatric radiologists was moderate to substantial for SAR-AGA standardized impressions and fair to moderate for key imaging findings of pediatric and young adult CD.

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Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA

    Mitchell A. Rees, Jonathan R. Dillman, Christopher G. Anton, Mantosh S. Rattan, Ethan A. Smith, Alexander J. Towbin & Andrew T. Trout

  2. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA

    Bin Zhang

Authors
  1. Mitchell A. Rees
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  2. Jonathan R. Dillman
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  4. Mantosh S. Rattan
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Correspondence to Mitchell A. Rees.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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The requirement for informed consent was waived by the institutional review board.

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Rees, M.A., Dillman, J.R., Anton, C.G. et al. Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease. Abdom Radiol 44, 391–397 (2019). https://doi.org/10.1007/s00261-018-1743-5

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