Key result
Cardiac computed tomography provides highly reproducible measurements for left atrial and left atrial appendage volumes, but visual assessment of morphological features shows only slight to fair agreement between readers.
Why the study?
Does cardiac computed tomography provide reproducible assessments of left atrial appendage volume and morphology in patients with suspected cardioembolic stroke/TIA?
Cross-Sectional (n=149)
Blinded to previous measurements and collateral readings
No
Does cardiac computed tomography provide reproducible assessments of left atrial appendage volume and morphology in patients with suspected cardioembolic stroke/TIA?
While cCT is highly reproducible for measuring LA and LAA volumes, visual classification of LAA morphology is subjective and poorly reproducible.
Answers are grounded in this paper and cite their sources.
cCT volumes support reliable LA/LAA quantification in stroke evaluation; leaves open standardization of morphological assessment.
OBJECTIVES: Left atrial appendage (LAA) dilatation and morphology may influence an individual's risk for intracardiac thrombi and ischemic stroke. LAA size and morphology can be evaluated using cardiac computed tomography (cCT). The present study evaluated the reproducibility of LAA volume and morphology assessments. METHODS: A total of 149 patients (47 females; mean age 60.9±10.6 years) with suspected cardioembolic stroke/transient ischemic attack underwent cCT. Image quality was rated based on four categories. Ten patients were selected from each image quality category (N = 40) for volumetric reproducibility analysis by two individual readers. LAA and left atrium (LA) volume were measured in both two-chamber (2CV) and transversal view (TV) orientation. Intertechnique reproducibility was assessed between 2CV and TV (200 measurement pairs). LAA morphology (A = Cactus, B = ChickenWing, C = WindSock, D = CauliFlower), LAA opening height, number of LAA lobes, trabeculation, and orientation of the LAA tip was analysed in all study subjects by three individual readers (447 interobserver measurement pairs). The reproducibility of volume measurements was assessed by intra-class correlation (ICC) and the reproducibility of LAA morphology assessments by Cohen's kappa. RESULTS: The intra-observer and interobserver reproducibility of LAA and LA volume measurements was excellent (ICCs>0.9). The LAA (ICC = 0.954) and LA (ICC = 0.945) volume measurements were comparable between 2CV and TV. Morphological classification (ĸ = 0.24) and assessments of LAA opening height (ĸ = 0.1), number of LAA lobes (ĸ = 0.16), trabeculation (ĸ = 0.15), and orientation of the LAA tip (ĸ = 0.37) was only slightly to fairly reproducible. CONCLUSIONS: LA and LAA volume measurements on cCT provide excellent reproducibility, whereas visual assessment of LAA morphological features is challenging and results in unsatisfactory agreement between readers.
No takes yet. Share an insight, caveat, or question.
Taina et al. (2014) conducted a cross-sectional in Suspected cardioembolic stroke or transient ischemic attack (n=149). Cardiac computed tomography (cCT) volumetric and morphological assessment vs. Inter-observer, intra-observer, and inter-technique comparisons was evaluated on Reproducibility of LAA and LA volume measurements (assessed by intra-class correlation) and LAA morphology assessments (assessed by Cohen's kappa) (ICC > 0.9 for volume; κ = 0.24 for morphology). Cardiac computed tomography provides highly reproducible measurements for left atrial and left atrial appendage volumes, but visual assessment of morphological features shows only slight to fair agreement between readers.
Synapse has enriched 10 related papers. Consider them for comparative context: