The Effect of Computer-Assisted Reporting on Interreader Variability of Lumbar Spine MRI Degenerative Findings: Five Readers With 30 Disc Levels.

PURPOSE: The aim of this study was to assess differences in interreader variability among radiologists after the implementation of a computer-assisted reporting (CAR) tool for the interpretation of degenerative disc disease on lumbar spine MRI.

METHODS

Thirty lumbar spine MRI examinations were selected from the radiology database. Five fellowship-trained musculoskeletal radiologists evaluated each L4-L5 disc in a blinded fashion and reported the findings using a traditional free dictation approach. One month later, they reinterpreted the same discs using a web browser-based CAR tool in the same blinded fashion. The degrees of central canal stenosis, neural foraminal stenosis, and facet joint osteoarthritis; presence or absence of lateral recess stenosis; types of disc bulge or herniation; and herniation location using both methods were recorded. Percentage disagreement among the radiologists for each variable was calculated and compared using the Wilcoxon signed rank test.

RESULTS

There was a statistically significant decrease among the five radiologists in percentage disagreement for neural foraminal stenosis (46% versus 35%, P = .0146) and facet joint osteoarthritis (45% and 22%, P < .0001) for reports created by free dictation compared with those created using the CAR tool. There was no statistically significant difference in interreader variability for the assessment of central canal stenosis, lateral recess effacement, disc herniation, disc bulge, or herniation location.

CONCLUSIONS

Implementation of a CAR tool for the interpretation of degenerative changes on lumbar spine MRI decreases interreader variability in the assessment of neural foraminal stenosis and facet joint osteoarthritis.