ArticleNeuroradiology2021
Callosal angle in idiopathic normal pressure hydrocephalus: small angular mal-rotations of the coronal plane affect measurement reliability.
Article in Neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Moving on in hydrocephalus imaging: from 2D to 3D biomarkers.Acta neurochirurgica · 2026Review
- Automatic coarse-to-fine AC-PC localization on CT using registration-guided 3D-UNets.Frontiers in neuroinformatics · 2026Article
- Automated deep learning pipeline for callosal angle quantification.Fluids and barriers of the CNS · 2025Article
- Splenial angle on axial T1 and fluid-attenuated inversion-recovery MRI images and idiopathic normal pressure hydrocephalus.The British journal of radiology · 2025Article
- The benefits of ventriculoperitoneal shunting in normal pressure hydrocephalus patients-a follow-up of three years.Acta neurochirurgica · 2024Article
- Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes.Neurology and therapy · 2023Article
- The Diagnostic Accuracy of Artificial Intelligence in Radiological Markers of Normal-Pressure Hydrocephalus (NPH) on Non-Contrast CT Scans of the Brain.Diagnostics (Basel, Switzerland) · 2023Article
- Clinical Features of Idiopathic Normal Pressure Hydrocephalus: Critical Review of Objective Findings.Movement disorders clinical practice · 2023Review
- Multiple Machine Learning Approaches for Morphometric Parameters in Prediction of Hydrocephalus.Brain sciences · 2022Article
- The splenial angle: a novel radiological index for idiopathic normal pressure hydrocephalus.European radiology · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeThe callosal angle (CA) is a useful biomarker in the diagnosis and management of idiopathic normal pressure hydrocephalus (NPH). Used incorrectly, CA measurements are variable, affecting its reliability as a clinical tool. Our objectives are to evaluate (i) reproducibility of established CA measurements between trained raters and (ii) impact of minor angular mal-rotations of the true coronal plane on CA measurements.
methodsCAs were measured by two independent raters on three-dimensional isovolumetric T1-weighted brain MRI of NPH patients and healthy controls using the established true coronal plane reformatted orthogonal to the plane containing the anterior-posterior commissural (AC-PC) line at the level of the posterior commissure. CA changes were subsequently evaluated when the coronal plane was mal-rotated by ± 5° and ± 10° in anterior-posterior and clockwise-anticlockwise directions. Inter-rater reliability of CA measurements was assessed using the intraclass correlation coefficient (ICC).
resultsOn the true coronal plane, inter-rater ICC was excellent (0.973) for NPH patients and good (0.875) for controls. On mal-rotated coronal plane setups, ICC for CA was worse in controls (0.484-0.886) than NPH (0.879-0.981) groups and in clockwise-anticlockwise (0.484-0.956) than anterior-posterior (0.503-0.981) mal-rotations. CA changes secondary to mal-rotations from the true coronal plane were significant in NPH patients (P < 0.0001 to 0.0378) but not in controls (P > 0.1).
conclusionThis is the first demonstration of how small angular mal-rotations of the coronal plane used for CA measurement affect its value and inter-rater reliability, highlighting the importance of a standardized protocol when measuring the CA in NPH workup.
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