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Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters

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Abstract

Purpose

To assess the inter- and intra-reader agreement of commonly used quantitative and qualitative image parameters for the assessment of degenerative lumbar spinal canal stenosis (LSS) by magnetic resonance imaging (MRI).

Methods

In this ethical board approved cross-sectional multicenter study, MRI of 100 randomly selected patients (median age 72.5 years, 48 % female) of the prospective Lumbar Stenosis Outcome Study (LSOS) were evaluated by two independent readers. A set of five previously published core imaging parameters as well as nine qualitative and five quantitative additional parameters regarding LSS and degenerative changes of the lumbar spine were assessed to calculate κ and intraclass correlation coefficients (ICC) for the inter-reader agreement. Additional repeated image evaluations were performed by one reader to calculate the intra-reader agreement.

Results

κ values for the core image parameters ranged between 0.42 (compromise of the foraminal zone) and 0.77 (relation between fluid and cauda equina) for inter-reader agreement and between 0.59 (compromise of the foraminal zone) and 0.8 (compromise of the central zone) for intra-reader agreement. The inter-reader agreement for the non-core parameters showed κ values of 0.27–0.69 and ICC values of 0.46–0.85. The intra-reader agreement showed κ values of 0.53–0.69 and ICC values of 0.81–0.88.

Conclusions

The inter- and intra-reader agreement of commonly used quantitative and qualitative image parameters for the assessment of LSS showed quite a variability with previously defined core parameters having good to excellent inter- and intra-reader agreements.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Sebastian Winklhofer, Tim Finkenstaedt & Gustav Andreisek

  2. Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, USA

    Sebastian Winklhofer

  3. Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland

    Ulrike Held, Jakob M. Burgstaller, Nicolae Bolog & Johann Steurer

  4. Department of Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland

    Nils Ulrich

  5. Institute of Diagnostic and Interventional Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland

    Filippo Del Grande

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  1. Sebastian Winklhofer
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  2. Ulrike Held
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  3. Jakob M. Burgstaller
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  4. Tim Finkenstaedt
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  7. Johann Steurer
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  8. Gustav Andreisek
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  9. Filippo Del Grande
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Correspondence to Sebastian Winklhofer.

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Conflict of interest

This study was supported by the Helmut Horten Foundation, OPO-Foundations, Symphasis Foundation, Baugarten Foundation and Pfizer-Foundation for geriatrics and research in geriatrics. We disclose any financial support or author involvement with organization(s) with financial interest in the subject matter.

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On behalf of the LSOS working group.

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Winklhofer, S., Held, U., Burgstaller, J.M. et al. Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters. Eur Spine J 26, 353–361 (2017). https://doi.org/10.1007/s00586-016-4667-1

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