Clinical Audit of Image Quality in Radiology Using Visual Grading Characteristics Analysis

Tesselaar, Erik; Dahlström, Nils; Sandborg, Michael

doi:10.1093/rpd/ncv411

Cited by 18 publications

(12 citation statements)

References 21 publications

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“…In another study of image quality Tesselaar et al compared lumbar spine radiographs in two different settings: Sensitivity class 400 (less noise) and sensitivity class 560 (more noise). They concluded that higher image quality produced higher inter-observer reliability, AC1 = 0.72 vs. 0.57 [14]. This is relevant to point out, since we, for economic reasons, used an open source image viewer for all image assessments.…”

Section: Discussionmentioning

confidence: 99%

European guidelines on quality criteria for diagnostic radiographic images of the lumbar spine – an intra- and inter-observer reproducibility study

et al. 2019

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Background The Commission of the European Communities has published guidelines to be used as a gold standard for quality assessment of diagnostic radiographic images. Image quality and radiation dose must be monitored and optimally balanced for diagnostic purposes on patients. The objective of the current study was to assess intra- and inter-observer reproducibility in less experienced observers using the proposed European Guidelines on Quality Criteria for Diagnostic Radiographic Images in a quality assessment of lumbar spine radiographs in primary chiropractic practice in Denmark. Methods Two observers initially evaluated lumbar spine radiographs randomly selected from fifty chiropractic clinics, all connected to the national PACS server (KirPACS) in Denmark. All evaluations were performed twice by both observers using a four-week interval and for compliance with the European Quality Criteria for Diagnostic Radiographic Images. Inter- and intra-observer reproducibility was calculated using kappa statistics. In the interpretation of the kappa coefficient, the standards for strength of agreement reported by Landis and Koch were followed. Results The strength of the inter-observer agreement of general image quality at baseline ranged from moderate agreement ( k = 0.47) to substantial agreement ( k = 0.68). After four weeks, the inter-observer agreement still ranged from moderate agreement ( k = 0.59) to substantial agreement ( k = 0.71), but with increased agreement for both kappa coefficients. In relation to intra-observer agreement of general image quality, the strength for observer A ranged from moderate ( k = 0.58) to substantial ( k = 0.72) and the strength for observer B overall was substantial ( k = 0.63–0.75). Conclusion The European Guidelines on Quality Criteria for Diagnostic Radiographic Images are considered a gold-standard and used in a method for quality assurance within the Danish chiropractic profession. The inter-rater and intra-rater agreements in this study, using the CEC-criteria, were found mostly acceptable. With appropriate attention to clear understanding of the individual criteria and sufficient training, this method is found to be reliable, even using less experienced observers, to carry out Diagnostic Radiographic Image Quality-assurance in primary care settings. Electronic supplementary material The online version of this article (10.1186/s12998-019-0241-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

European guidelines on quality criteria for diagnostic radiographic images of the lumbar spine – an intra- and inter-observer reproducibility study

et al. 2019

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“…Visual grading analysis permits an image or parts of an image to be evaluated visually and has been validated in human radiology, as an analytical system for image quality . Using predefined imaging criteria allows the quantification of subjective opinions into a scoring system making them amenable to statistical analysis .…”

Section: Discussionmentioning

confidence: 99%

Improved visualization of the lumbar spine nerve roots in dogs using water excitation (ProSet) as opposed to short tau inversion recovery: A retrospective study of two fat suppression MRI sequences

Bergamino

Hoey

Swarte

et al. 2019

Vet Radiology Ultrasound

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Magnetic resonance imaging fat suppression techniques are commonly used for diagnosis of canine spinal disease, however, studies comparing different techniques are currently lacking. This retrospective, methods comparison study aimed to evaluate water excitation and STIR MRI pulse sequences for visualization of canine lumbar spinal nerve roots. For inclusion, all dogs had to have dorsal planar MRI studies of the lumbar spine using both sequences. Visual grading analysis was used for scoring the following five criteria: degree of fat suppression; nerve root visualization; subjective tissue contrast; presence of noise; and overall better image quality. Scores were independently recorded by three board-certified veterinary radiologists on two separate occasions, 3-6 weeks apart. A total of 90 dogs were sampled. A two-tailed t-test showed that there were significant differences in all scored parameters (P < 0.00001), with the exception of noise (P = 0.47343), and that the water excitation sequence scored higher in all cases excluding noise. A Gwets AC kappa for intraobserver and interobserver reliability showed "almost perfect" agreement for the nerve roots in both tests (intra: k = 0.88; inter: k = 0.90). Intraobserver agreement was "substantial" for the degree of fat suppression (k = 0.68), subjective tissue contrast (k = 0.75), and overall better image quality (k = 0.76) and it was "fair" for the noise (k = 0.46). Interobserver agreement was "moderate" for the degree of fat suppression (k = 0.53), subjective tissue contrast (k = 0.63), and overall better image quality (k = 0.66) and "slight" for noise (k = 0.25). These findings supported using the water excitation pulse sequence for fat-suppressed MRI of canine lumbar spinal nerve roots.

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“…It is dependent on the readers' ability to detect and correctly interpret the visible pathology. For the above reasons a standard ROC study is a time-consuming and costly method that requires a large number of cases to produce statistically significant results and may not be a practical choice for optimisation purposes [58].…”

Section: Receiver Operating Characteristic (Roc)mentioning

confidence: 99%

“…iii. Participating observer time workload is moderate, hence multiple observers can participate leading to an increase in statistical power of the result [58,60]. iv.…”

Section: Visual Grading Experimentsmentioning

confidence: 99%

“…Since visual grading studies are relatively fast, effective and require less resources than a ROC study, they are economically justifiable [52]. In contrast to ROC methods, visual grading experiments focus on the reproduction accuracy of normal anatomy and assume that if visibility and/or reproduction of a certain anatomical structure is possible, then the same applies to pathology [58]. However, it is generally not known to what extent this assumption is true or not.…”

Section: Visual Grading Experimentsmentioning

confidence: 99%

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Visual grading evaluation of reconstruction methods and dose optimisation in abdominal Computed Tomography

Kataria

2019

Linköping University Medical Dissertations

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Clinical Audit of Image Quality in Radiology Using Visual Grading Characteristics Analysis

Cited by 18 publications

References 21 publications

European guidelines on quality criteria for diagnostic radiographic images of the lumbar spine – an intra- and inter-observer reproducibility study

European guidelines on quality criteria for diagnostic radiographic images of the lumbar spine – an intra- and inter-observer reproducibility study

Improved visualization of the lumbar spine nerve roots in dogs using water excitation (ProSet) as opposed to short tau inversion recovery: A retrospective study of two fat suppression MRI sequences

Visual grading evaluation of reconstruction methods and dose optimisation in abdominal Computed Tomography

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