The objectives of this retrospective, observer agreement study were to (a) test variability of radiographic left atrial dimension (RLAD) and vertebral left atrial size (VLAS) measurements among observers with different levels of expertise in thoracic radiology and cardiology, (b) assess whether one method is better than the other in detecting left atrial enlargement (LAE), and (c) assess the agreement among RLAD, VLAS, and American College of Veterinary Internal Medicine (ACVIM) classes. Seventy-four dogs (eight healthy and 66 with mitral valve disease) with thoracic radiographs and echocardiography performed on the same day were reviewed. Thirty showed echocardiographic LAE. Left atrial dimension was quantified using RLAD and VLAS by six different operators with three levels of clinical experience in veterinary cardiology/radiology. Vertebral heart score and fourth thoracic vertebra (T4) were also measured. Differences in T4, vertebral heart score (VHS), RLAD, and VLAS measurements were found among six operators and among the three levels of clinical expertise as well as between veterinary cardiology readers and veterinary radiology readers (P < .05). The area under the receiver operating characteristic (AUC) curve for VHS showed good performances for all observers and level and type of expertise; the AUC for RLAD and VLAS was suboptimal only for the radiology student. Our RLAD and VLAS cutoffs (1.9 and 2.43 v, respectively) were better related to qualitative radiographic than quantitative echocardiographic LAE evaluation. Radiographic LA dimension and VLAS showed an increase proportional to the worsening of the ACVIM class. In conclusion, these results allow us to affirm that RLAD and VLAS are reproducible measurements for detecting LAE. Better performances are associated with clinical expertise and background.

Interobserver variability of radiographic methods for the evaluation of left atrial size in dogs / M. Bagardi, M. Manfredi, D.D. Zani, P.G. Brambilla, C. Locatelli. - In: VETERINARY RADIOLOGY & ULTRASOUND. - ISSN 1058-8183. - (2020). [Epub ahead of print] [10.1111/vru.12930]

Interobserver variability of radiographic methods for the evaluation of left atrial size in dogs

M. Bagardi
Primo
;
M. Manfredi
Secondo
;
D.D. Zani;P.G. Brambilla
Penultimo
;
C. Locatelli
Ultimo
2020

Abstract

The objectives of this retrospective, observer agreement study were to (a) test variability of radiographic left atrial dimension (RLAD) and vertebral left atrial size (VLAS) measurements among observers with different levels of expertise in thoracic radiology and cardiology, (b) assess whether one method is better than the other in detecting left atrial enlargement (LAE), and (c) assess the agreement among RLAD, VLAS, and American College of Veterinary Internal Medicine (ACVIM) classes. Seventy-four dogs (eight healthy and 66 with mitral valve disease) with thoracic radiographs and echocardiography performed on the same day were reviewed. Thirty showed echocardiographic LAE. Left atrial dimension was quantified using RLAD and VLAS by six different operators with three levels of clinical experience in veterinary cardiology/radiology. Vertebral heart score and fourth thoracic vertebra (T4) were also measured. Differences in T4, vertebral heart score (VHS), RLAD, and VLAS measurements were found among six operators and among the three levels of clinical expertise as well as between veterinary cardiology readers and veterinary radiology readers (P < .05). The area under the receiver operating characteristic (AUC) curve for VHS showed good performances for all observers and level and type of expertise; the AUC for RLAD and VLAS was suboptimal only for the radiology student. Our RLAD and VLAS cutoffs (1.9 and 2.43 v, respectively) were better related to qualitative radiographic than quantitative echocardiographic LAE evaluation. Radiographic LA dimension and VLAS showed an increase proportional to the worsening of the ACVIM class. In conclusion, these results allow us to affirm that RLAD and VLAS are reproducible measurements for detecting LAE. Better performances are associated with clinical expertise and background.
X-ray; canine; left atrial dimension; mitral valve disease
Settore VET/08 - Clinica Medica Veterinaria
Settore VET/09 - Clinica Chirurgica Veterinaria
2020
23-nov-2020
Article (author)
File in questo prodotto:
File Dimensione Formato  
Bagardi 2020.pdf

Open Access dal 01/12/2021

Tipologia: Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Dimensione 485.19 kB
Formato Adobe PDF
485.19 kB Adobe PDF Visualizza/Apri
vru.12930(1).pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 1.29 MB
Formato Adobe PDF
1.29 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/793718
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 14
social impact