Evidence map›Paper›PMID 32877415›Full record

ArticlePloS one2020

Multiple reader comparison of 2D TOF, 3D TOF, and CEMRA in screening of the carotid bifurcations: Time to reconsider routine contrast use?

Jeffrey S Ross, Skye A Buckner Petty, Waleed Brinjikji, Joseph M Hoxworth, Vance T Lehman, Erik H Middlebrooks, Ameet C Patel, Christopher P Wood

Open access · goldAbstract readComparative Study
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Jeffrey S RossDepartment of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America.ORCID 0000-0001-5865-6828
Skye A Buckner PettyDepartment of Research Biostatistics, Mayo Clinic Arizona, Phoenix, Arizona, United States of America.
Waleed BrinjikjiDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, United States of America.
Joseph M HoxworthDepartment of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America.ORCID 0000-0002-7179-5846
Vance T LehmanDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, United States of America.
Erik H MiddlebrooksDepartment of Radiology, Mayo Clinic Jacksonville, Jacksonville, Florida, United States of America.
Ameet C PatelDepartment of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America.ORCID 0000-0002-2916-2754
Christopher P WoodDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, United States of America.
Mayo Clinic · USMayo Clinic Hospital · USJacksonville College · USMayo Clinic in Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeMR contrast-enhanced techniques are undergoing increased scrutiny since the FDA applied a warning for gadolinium-based MR contrast agents due to gadolinium deposition within multiple organ systems. While CE-MRA provides excellent image quality, is it required in a screening carotid study? This study compares 2D TOF and 3D TOF MRA vs. CE-MRA in defining carotid stenosis in a large clinical patient population, and with multiple readers with varying experience. MATERIALS AND

methods200 consecutive patients had their carotid bifurcations evaluated with 2D TOF, 3D TOF and CE-MRA sequences by 6 board-certified neuroradiologists. Stenosis and quality of examinations were defined for each study. Inter-rater reliability was assessed using two-way random effects intraclass correlation coefficients. Intra-reader reliability was computed via weighted Cohen's κ. Weighted Cohen's κ were also computed to assess agreement in stenosis ratings between enhanced images and unenhanced images.

resultsAgreement between unenhanced and enhanced ratings was substantial with a pooled weighted κ of 0.733 (0.628-0.811). For 5 of the 6 readers, the combination of unenhanced 2D TOF and 3D TOF showed better agreement with contrast-enhanced than either 2D TOF or 3D TOF alone. Intra-reader reliability was substantial.

conclusionsThe combination of 2D TOF and 3D TOF MRA showed substantial agreement with CE-MRA regarding degree of carotid stenosis in this large outpatient population across multiple readers of varying experience. Given the scrutiny that GBCA are undergoing due to concerns regarding CNS and soft tissue deposition, it seems prudent to reserve CE-MRA for cases which are not satisfactorily answered by the nonenhanced study or other noninvasive examinations.

Indexed as

Imaging, Three-DimensionalMagnetic Resonance AngiographyAdultAgedAged, 80 and overCarotid ArteriesContrast MediaFemaleHumansMaleMiddle AgedReproducibility of ResultsContrast Media

Identifiers

PMID32877415
PMCPMC7467222
OpenAlexW3082784665

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.