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Neuroimaging
Original research
In vitro accuracy and inter-observer reliability of CT angiography in detecting intracranial aneurysm enlargement
  1. Sami Al Kasab1,2,
  2. Daichi Nakagawa3,
  3. Mario Zanaty4,
  4. Girish Bathla5,
  5. Bruno Policeni5,
  6. Neetu Soni5,
  7. Lauren Allan6,
  8. Joseph Hudson7,
  9. Kaustubh Limaye8,
  10. Santiago Ortega-Gutierrez9,
  11. Edgar A Samaniego10,
  12. David Hasan11
  1. 1 Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2 Neurology, University of Iowa Hospitals and Clinics, Iowa, IA, USA
  3. 3 Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  4. 4 Neurosurgery, University of Iowa, Iowa City, Iowa, USA
  5. 5 Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  6. 6 Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  7. 7 University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  8. 8 Neurology, University of Iowa, Iowa City, Iowa, USA
  9. 9 Division of Neurointerventional Surgery-Interventional Neuroradiology, University of Iowa, Iowa City, Iowa, USA
  10. 10 Neurology, Neurosurgery and Radiology, University of Iowa, Iowa City, Iowa, USA
  11. 11 Neurological surgery, University of Iowa, Iowa City, Iowa, USA
  1. Correspondence to Dr David Hasan, Neurological surgery, University of Iowa, Iowa City IA 52240, USA; david-hasan{at}uiowa.edu

Abstract

Background and purpose To evaluate the accuracy and inter-observer variability when CT angiography is used to identify unruptured intracranial aneurysm growth.

Methods Two silicone phantom models were used in this study. Each phantom had eight aneurysms of variable size. The size and location of aneurysms in phantom 1 were representative of real patient aneurysms who presented to our institution. Phantom 2 contained aneurysms in the same locations, but with enlargement in various directions. Three blinded board-certified neuroradiologists were asked to identify the size of each aneurysm in three dimensions using CT angiography. The individual enlargement detection rates and inter-observer agreement rates of aneurysm enlargement among the three experts were calculated.

Results The detection rate of aneurysm enlargement in one dimension was 58.3% among the three observers. Accurate detection of enlargement in all dimensions was 12.5% among the three observers. Detection accuracy was not related to the size of enlargement. Significant inter-observer measurement variability was present.

Conclusion The use of CT angiography was associated with a poor ability to identify aneurysm enlargementaccurately. Further human studies are required to confirm our findings.

  • aneurysm
  • growth
  • measurement
  • CT angiography

https://doi.org/10.1136/neurintsurg-2019-014737

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    Footnotes

    • Contributors SAK, DN, and DH contributed to the conception, design, data analysis, drafting and revising the manuscript. GB, BP, NS analyzed the data. MZ, JH, KL, SO-G, ES drafted and revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.