Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings

Mark J. Hancock; Chris G. Maher; Jeffrey G. Jarvik; Michele C. Battié; James M. Elliott; Tue S. Jensen; John Panagopoulos; Hazel Jenkins; Margery C. Pardey; Jeffery McIntosh; John Magnussen

doi:10.1002/pmrj.12705

Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings

Mark J. Hancock^*, Chris G. Maher, Jeffrey G. Jarvik, Michele C. Battié, James M. Elliott, Tue S. Jensen, John Panagopoulos, Hazel Jenkins, Margery C. Pardey, Jeffery McIntosh, John Magnussen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: The importance of lumbar findings on magnetic resonance imaging (MRI) remains controversial. Changes in lumbar MRI findings over time may provide important insights into the causes of low back pain. However, the reliability and validity of temporal changes are unknown. Objective: To (1) investigate the interrater reliability of subjective radiologist reporting of temporal changes in lumbar spine MRI findings and (2) determine how commonly temporal changes are reported when two scans are conducted 30 minutes apart (considered false positives). Design: Cross-sectional study. Setting: Radiology clinic. Participants: Forty volunteers (mean age 40; 53% female) with current (n = 31) or previous (n = 9) low back pain underwent initial lumbar MRI on a single 3T scanner. Participants then lay on a bed for 30 minutes before undergoing an identical MRI. In addition, we purposely selected five participants from a previous study with repeat lumbar MRI scans where temporal changes were reported in at least one MRI finding (1–12 weeks after initial scan) and another five participants where no temporal change was reported. The 10 participants were included in analyses for aim 1 only. Interventions: Not applicable. Main Outcome Measures: Two blinded radiologists reported on temporal changes between the baseline and repeat scan for 12 different MRI findings (eg, disk herniation, annular fissure) at five levels. Results: The interrater reliability of subjective reporting of temporal changes was poor for all MRI findings based on Kappa values (≤ 0.24), but agreement was relatively high (≥ 90.8%). This is explained by the low prevalence of temporal changes as demonstrated by high values for Prevalence and Bias Adjusted Kappa (≥ 0.82). “False positive” temporal changes were reported by at least one radiologist for most MRI findings, but the rate was generally low. Conclusions: Caution is required when interpreting temporal changes in lumbar MRI findings owing to low reliability and some false positive reporting.

Original language	English
Journal	PM and R
Volume	14
Issue	11
Pages (from-to)	1325-1332
Number of pages	8
ISSN	1934-1482
DOIs	https://doi.org/10.1002/pmrj.12705
Publication status	Published - Nov 2022

Keywords

Adult
Cross-Sectional Studies
Female
Humans
Low Back Pain/diagnostic imaging
Lumbar Vertebrae/diagnostic imaging
Magnetic Resonance Imaging/methods
Male
Radiologists
Reproducibility of Results

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10.1002/pmrj.12705

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@article{5a06318fedce4bf7b169a0f38b0f64f8,

title = "Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings",

abstract = "Background: The importance of lumbar findings on magnetic resonance imaging (MRI) remains controversial. Changes in lumbar MRI findings over time may provide important insights into the causes of low back pain. However, the reliability and validity of temporal changes are unknown. Objective: To (1) investigate the interrater reliability of subjective radiologist reporting of temporal changes in lumbar spine MRI findings and (2) determine how commonly temporal changes are reported when two scans are conducted 30 minutes apart (considered false positives). Design: Cross-sectional study. Setting: Radiology clinic. Participants: Forty volunteers (mean age 40; 53% female) with current (n = 31) or previous (n = 9) low back pain underwent initial lumbar MRI on a single 3T scanner. Participants then lay on a bed for 30 minutes before undergoing an identical MRI. In addition, we purposely selected five participants from a previous study with repeat lumbar MRI scans where temporal changes were reported in at least one MRI finding (1–12 weeks after initial scan) and another five participants where no temporal change was reported. The 10 participants were included in analyses for aim 1 only. Interventions: Not applicable. Main Outcome Measures: Two blinded radiologists reported on temporal changes between the baseline and repeat scan for 12 different MRI findings (eg, disk herniation, annular fissure) at five levels. Results: The interrater reliability of subjective reporting of temporal changes was poor for all MRI findings based on Kappa values (≤ 0.24), but agreement was relatively high (≥ 90.8%). This is explained by the low prevalence of temporal changes as demonstrated by high values for Prevalence and Bias Adjusted Kappa (≥ 0.82). “False positive” temporal changes were reported by at least one radiologist for most MRI findings, but the rate was generally low. Conclusions: Caution is required when interpreting temporal changes in lumbar MRI findings owing to low reliability and some false positive reporting.",

keywords = "Adult, Cross-Sectional Studies, Female, Humans, Low Back Pain/diagnostic imaging, Lumbar Vertebrae/diagnostic imaging, Magnetic Resonance Imaging/methods, Male, Radiologists, Reproducibility of Results",

author = "Hancock, {Mark J.} and Maher, {Chris G.} and Jarvik, {Jeffrey G.} and Batti{\'e}, {Michele C.} and Elliott, {James M.} and Jensen, {Tue S.} and John Panagopoulos and Hazel Jenkins and Pardey, {Margery C.} and Jeffery McIntosh and John Magnussen",

note = "{\textcopyright} 2021 American Academy of Physical Medicine and Rehabilitation.",

year = "2022",

month = nov,

doi = "10.1002/pmrj.12705",

language = "English",

volume = "14",

pages = "1325--1332",

journal = "PM and R",

issn = "1934-1482",

publisher = "Elsevier Inc.",

number = "11",

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Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings. / Hancock, Mark J.; Maher, Chris G.; Jarvik, Jeffrey G. et al.
In: PM and R, Vol. 14, No. 11, 11.2022, p. 1325-1332.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings

AU - Hancock, Mark J.

AU - Maher, Chris G.

AU - Jarvik, Jeffrey G.

AU - Battié, Michele C.

AU - Elliott, James M.

AU - Jensen, Tue S.

AU - Panagopoulos, John

AU - Jenkins, Hazel

AU - Pardey, Margery C.

AU - McIntosh, Jeffery

AU - Magnussen, John

PY - 2022/11

Y1 - 2022/11

N2 - Background: The importance of lumbar findings on magnetic resonance imaging (MRI) remains controversial. Changes in lumbar MRI findings over time may provide important insights into the causes of low back pain. However, the reliability and validity of temporal changes are unknown. Objective: To (1) investigate the interrater reliability of subjective radiologist reporting of temporal changes in lumbar spine MRI findings and (2) determine how commonly temporal changes are reported when two scans are conducted 30 minutes apart (considered false positives). Design: Cross-sectional study. Setting: Radiology clinic. Participants: Forty volunteers (mean age 40; 53% female) with current (n = 31) or previous (n = 9) low back pain underwent initial lumbar MRI on a single 3T scanner. Participants then lay on a bed for 30 minutes before undergoing an identical MRI. In addition, we purposely selected five participants from a previous study with repeat lumbar MRI scans where temporal changes were reported in at least one MRI finding (1–12 weeks after initial scan) and another five participants where no temporal change was reported. The 10 participants were included in analyses for aim 1 only. Interventions: Not applicable. Main Outcome Measures: Two blinded radiologists reported on temporal changes between the baseline and repeat scan for 12 different MRI findings (eg, disk herniation, annular fissure) at five levels. Results: The interrater reliability of subjective reporting of temporal changes was poor for all MRI findings based on Kappa values (≤ 0.24), but agreement was relatively high (≥ 90.8%). This is explained by the low prevalence of temporal changes as demonstrated by high values for Prevalence and Bias Adjusted Kappa (≥ 0.82). “False positive” temporal changes were reported by at least one radiologist for most MRI findings, but the rate was generally low. Conclusions: Caution is required when interpreting temporal changes in lumbar MRI findings owing to low reliability and some false positive reporting.

AB - Background: The importance of lumbar findings on magnetic resonance imaging (MRI) remains controversial. Changes in lumbar MRI findings over time may provide important insights into the causes of low back pain. However, the reliability and validity of temporal changes are unknown. Objective: To (1) investigate the interrater reliability of subjective radiologist reporting of temporal changes in lumbar spine MRI findings and (2) determine how commonly temporal changes are reported when two scans are conducted 30 minutes apart (considered false positives). Design: Cross-sectional study. Setting: Radiology clinic. Participants: Forty volunteers (mean age 40; 53% female) with current (n = 31) or previous (n = 9) low back pain underwent initial lumbar MRI on a single 3T scanner. Participants then lay on a bed for 30 minutes before undergoing an identical MRI. In addition, we purposely selected five participants from a previous study with repeat lumbar MRI scans where temporal changes were reported in at least one MRI finding (1–12 weeks after initial scan) and another five participants where no temporal change was reported. The 10 participants were included in analyses for aim 1 only. Interventions: Not applicable. Main Outcome Measures: Two blinded radiologists reported on temporal changes between the baseline and repeat scan for 12 different MRI findings (eg, disk herniation, annular fissure) at five levels. Results: The interrater reliability of subjective reporting of temporal changes was poor for all MRI findings based on Kappa values (≤ 0.24), but agreement was relatively high (≥ 90.8%). This is explained by the low prevalence of temporal changes as demonstrated by high values for Prevalence and Bias Adjusted Kappa (≥ 0.82). “False positive” temporal changes were reported by at least one radiologist for most MRI findings, but the rate was generally low. Conclusions: Caution is required when interpreting temporal changes in lumbar MRI findings owing to low reliability and some false positive reporting.

KW - Adult

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Low Back Pain/diagnostic imaging

KW - Lumbar Vertebrae/diagnostic imaging

KW - Magnetic Resonance Imaging/methods

KW - Male

KW - Radiologists

KW - Reproducibility of Results

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U2 - 10.1002/pmrj.12705

DO - 10.1002/pmrj.12705

M3 - Journal article

C2 - 34510774

AN - SCOPUS:85117188628

SN - 1934-1482

VL - 14

SP - 1325

EP - 1332

JO - PM and R

JF - PM and R

IS - 11

ER -

Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings

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