Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Semi-Quantitative Scoring of Late Gadolinium Enhancement of the Left Ventricle in Patients with Ischemic Cardiomyopathy: Improving Interobserver Reliability and Agreement Using Consensus Guidance from the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) 2020

  • Cherry Kim (Department of Radiology, Korea University Ansan Hospital) ;
  • Chul Hwan Park (Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Do Yeon Kim (Biomedical Research Center, Korea University Ansan Hospital) ;
  • Jaehyung Cha (Biomedical Research Center, Korea University Ansan Hospital) ;
  • Bae Young Lee (Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chan Ho Park (Department of Radiology, Soonchunhyang University Cheonan Hospital) ;
  • Eun-Ju Kang (Department of Radiology, College of Medicine, Dong-A University) ;
  • Hyun Jung Koo (Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kakuya Kitagawa (Department of Radiology, Mie University Graduate School of Medicine) ;
  • Min Jae Cha (Department of Radiology, Chung-Ang University Hospital) ;
  • Rungroj Krittayaphong (Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University) ;
  • Sang Il Choi (Department of Radiology, Seoul University Bundang Hospital) ;
  • Sanjaya Viswamitra (Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences) ;
  • Sung Min Ko (Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital) ;
  • Sung Mok Kim (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung Ho Hwang (Department of Radiology, Korea University Anam Hospital) ;
  • Nguyen Ngoc Trang (Radiology Center, Bach Mai University Hospital) ;
  • Whal Lee (Department of Radiology, Seoul University Hospital) ;
  • Young Jin Kim (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Jongmin Lee (Department of Radiology, Kyungpook National University Hospital) ;
  • Dong Hyun Yang (Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2021.05.10
  • Accepted : 2021.10.18
  • Published : 2022.03.01
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Abstract

Objective: This study aimed to evaluate the effect of implementing the consensus statement from the Asian Society of Cardiovascular Imaging-Practical Tutorial 2020 (ASCI-PT 2020) on the reliability of cardiac MR with late gadolinium enhancement (CMR-LGE) myocardial viability scoring between observers in the context of ischemic cardiomyopathy. Materials and Methods: A total of 17 cardiovascular imaging experts from five different countries evaluated CMR obtained in 26 patients (male:female, 23:3; median age [interquartile range], 55.5 years [50-61.8]) with ischemic cardiomyopathy. For LGE scoring, based on the 17 segments, the extent of LGE in each segment was graded using a five-point scoring system ranging from 0 to 4 before and after exposure according to the consensus statement. All scoring was performed via web-based review. Scores for slices, vascular territories, and total scores were obtained as the sum of the relevant segmental scores. Interobserver reliability for segment scores was assessed using Fleiss' kappa, while the intraclass correlation coefficient (ICC) was used for slice score, vascular territory score, and total score. Inter-observer agreement was assessed using the limits of agreement from the mean (LoA). Results: Interobserver reliability (Fleiss' kappa) in each segment ranged 0.242-0.662 before the consensus and increased to 0.301-0.774 after the consensus. The interobserver reliability (ICC) for each slice, each vascular territory, and total score increased after the consensus (slice, 0.728-0.805 and 0.849-0.884; vascular territory, 0.756-0.902 and 0.852-0.941; total score, 0.847 and 0.913, before and after implementing the consensus statement, respectively. Interobserver agreement in scoring also improved with the implementation of the consensus for all slices, vascular territories, and total score. The LoA for the total score narrowed from ± 10.36 points to ± 7.12 points. Conclusion: The interobserver reliability and agreement for CMR-LGE scoring for ischemic cardiomyopathy improved when following guidance from the ASCI-PT 2020 consensus statement.

Keywords

Acknowledgement

ASCI-PT 2020 was supported by Dongkook Life Science and Circle financially. We thank them for their support.

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