ArticleTomography (Ann Arbor, Mich.)2022
Diagnostic Accuracy and Reliability of Noncontrast Computed Tomography Markers for Acute Hematoma Expansion among Radiologists.
Article in Tomography (Ann Arbor, Mich.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Temporal evolution of non-contrast CT markers of expansion relates to the dynamics of acute intracerebral hemorrhage.Neuroradiology · 2025Observational
- A Hybrid Transformer-Convolutional Neural Network for Segmentation of Intracerebral Hemorrhage and Perihematomal Edema on Non-Contrast Head Computed Tomography (CT) with Uncertainty Quantification to Improve Confidence.Bioengineering (Basel, Switzerland) · 2024Article
- Uncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan.NPJ digital medicine · 2024Article
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Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNoncontrast Computed Tomography (NCCT) features are promising markers for acute hematoma expansion (HE) in patients with intracerebral hemorrhage (ICH). It remains unclear whether accurate identification of these markers is also reliable in raters with different levels of experience.
methodsPatients with acute spontaneous ICH admitted at four tertiary centers in Germany and Italy were retrospectively included from January 2017 to June 2020. In total, nine NCCT markers were rated by one radiology resident, one radiology fellow, and one neuroradiology fellow with different levels experience in ICH imaging. Interrater reliabilities of the resident and radiology fellow were evaluated by calculated Cohen's kappa (κ) statistics in reference to the neuroradiology fellow who was referred as the gold standard. Gold-standard ratings were evaluated by calculated interrater κ statistics. Global interrater reliabilities were evaluated by calculated Fleiss kappa statistics across all three readers. A comparison of receiver operating characteristics (ROCs) was used to evaluate differences in the diagnostic accuracy for predicting acute hematoma expansion (HE) among the raters.
resultsSubstantial-to-almost-perfect interrater concordance was found for the resident with interrater Cohen's kappa from 0.70 (95% CI 0.65-0.81) to 0.96 (95% CI 0.94-0.98). The interrater Cohen's kappa for the radiology fellow was moderate to almost perfect and ranged from 0.58 (95% CI 0.52-0.65) to 94 (95% CI 92-0.97). The intrarater gold-standard Cohen's kappa was almost perfect and ranged from 0.79 (95% CI 0.78-0.90) to 0.98 (95% CI 0.78-0.90). The global interrater Fleiss kappa ranged from 0.62 (95%CI 0.57-0.66) to 0.93 (95%CI 0.89-0.97). The diagnostic accuracy for the prediction of acute hematoma expansion (HE) was different for the island sign and fluid sign, with
conclusionThe NCCT markers had a substantial-to-almost-perfect interrater agreement among raters with different levels of experience. Differences in the diagnostic accuracy for the prediction of acute HE were found in two out of nine NCCT markers. The study highlights the promising utility of NCCT markers for acute HE prediction.
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