AJNR. American journal of neuroradiology · 2026
Detection of Optic Canal Invasion in Suprasellar Meningiomas on MRI: Education Improves Clinician Accuracy and Interrater Reliability.
СтатьяНазвание и аннотация: Перевод в очереди
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Kim Boaz, Houlihan Conor, Castle-Kirszbaum Mendel, Kam Jeremy, Gan Calvin, Gogos Andrew, Praeger Adrian, Slater Lee-Anne, Lai Leon, Moore Justin, King James, Goldschlager Tony, Amukotuwa Shalini
Аннотация
BACKGROUND AND PURPOSE: Preoperative detection and localization of optic canal invasion (OCI) in suprasellar meningiomas is important to guide surgical decision-making and clinical prognosis. However, OCI assessment is not standardized, and can be challenging to determine radiologically. This study aimed to assess the diagnostic performance of different clinician groups in identifying OCI on preoperative MRI, and the effect of targeted education on performance and interrater reliability.
MATERIALS AND METHODS: Twenty-six consecutive preoperative MRI studies of patients who underwent surgery for suprasellar meningiomas between January 2014 and December 2023 were included. Twenty-five clinician readers from 5 different clinician groups (general neurosurgeons, general radiologists, skull base fellowship neurosurgeons, radiology trainees, neurosurgery trainees) independently assessed the imaging for presence and location of OCI. Three months later, each reader repeated the assessment after targeted education. Diagnostic performance was analyzed by calculating accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve. Consensus interpretation by 2 fellowship-trained neuroradiologists served as the reference standard. Interrater reliability was determined using Scott/Fleiss κ statistics.
RESULTS: Pre-education median accuracy for detecting medial canal invasion ranged from 57%-65% across the 5 groups and was approximately 80% for lateral canal invasion. After education, accuracy of all clinician groups increased regardless of level of training and years of experience to 77%-85% for medial canal invasion median accuracy range and approximately 90% for lateral canal invasion. There was statistically significant improvement in diagnostic accuracy in each of the 5 clinician groups after education, except for lateral canal invasion scores in 1 clinician group. Interrater reliability following targeted education increased from very poor (κ < 0.1) to moderate agreement (κ = 0.4-0.5) for medial canal invasion and from fair (κ = 0.2-0.4) to moderate (κ = 0.4-0.6) agreement for lateral canal invasion.
CONCLUSIONS: All clinician groups, regardless of their level of training or clinical experience, had relatively poor diagnostic performance for detecting and localizing OCI in suprasellar meningiomas before education when compared with neuroradiologists. Education improved both accuracy and interrater reliability. Our study supports the case for targeted radiologic education in other similar subspecialty neuroradiologic topics of clinical importance.
MATERIALS AND METHODS: Twenty-six consecutive preoperative MRI studies of patients who underwent surgery for suprasellar meningiomas between January 2014 and December 2023 were included. Twenty-five clinician readers from 5 different clinician groups (general neurosurgeons, general radiologists, skull base fellowship neurosurgeons, radiology trainees, neurosurgery trainees) independently assessed the imaging for presence and location of OCI. Three months later, each reader repeated the assessment after targeted education. Diagnostic performance was analyzed by calculating accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve. Consensus interpretation by 2 fellowship-trained neuroradiologists served as the reference standard. Interrater reliability was determined using Scott/Fleiss κ statistics.
RESULTS: Pre-education median accuracy for detecting medial canal invasion ranged from 57%-65% across the 5 groups and was approximately 80% for lateral canal invasion. After education, accuracy of all clinician groups increased regardless of level of training and years of experience to 77%-85% for medial canal invasion median accuracy range and approximately 90% for lateral canal invasion. There was statistically significant improvement in diagnostic accuracy in each of the 5 clinician groups after education, except for lateral canal invasion scores in 1 clinician group. Interrater reliability following targeted education increased from very poor (κ < 0.1) to moderate agreement (κ = 0.4-0.5) for medial canal invasion and from fair (κ = 0.2-0.4) to moderate (κ = 0.4-0.6) agreement for lateral canal invasion.
CONCLUSIONS: All clinician groups, regardless of their level of training or clinical experience, had relatively poor diagnostic performance for detecting and localizing OCI in suprasellar meningiomas before education when compared with neuroradiologists. Education improved both accuracy and interrater reliability. Our study supports the case for targeted radiologic education in other similar subspecialty neuroradiologic topics of clinical importance.