MRI evaluation of neurofibromatosis 2 patients: a standardized approach for accuracy in interpretation

Otol Neurotol. 2005 Jul;26(4):733-40. doi: 10.1097/01.mao.0000169048.15889.80.

Abstract

Objective: To determine the level of agreement between local radiologists' and an experienced neuroradiologist's measurements of vestibular schwannomas.

Study design: Prospective study with uniform magnetic resonance acquisition protocol parameters and reporting instructions across 30 magnetic resonance imaging facilities worldwide.

Setting: Multicenter natural history study of neurofibromatosis Type 2.

Subjects: One hundred fifteen magnetic resonance imaging examinations of 57 neurofibromatosis Type 2 patients older than 5 years of age.

Interventions: Thin-slice, postcontrast cranial magnetic resonance imaging.

Main outcome measures: Spearman's rho interobserver association coefficient of vestibular schwannoma linear measurements.

Results: The local and experienced radiologist measurements and identification of tumors agreement was fair (kappa = 0.77). Discordant interpretations were adjudicated by another experienced neuroradiologist.

Conclusion: The least interobserver variability was found in measurements of thin-slice postcontrast magnetic resonance imaging scans obtained at neurofibromatosis Type 2 centers in patients without previous operations and moderately sized tumors. If the schwannoma was difficult to assess, because of magnetic resonance imaging acquisition protocol, postoperative changes, or tumors smaller than 5 mm in greatest diameter, the neuroradiologist provided a more thorough assessment. The authors suggest uniform reporting criteria for vestibular schwannoma assessments to ensure clinically relevant information is communicated regarding vestibular schwannoma size.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Magnetic Resonance Imaging* / standards
  • Male
  • Neurofibromatosis 2 / diagnosis*
  • Observer Variation
  • Prospective Studies
  • Reference Standards
  • Reproducibility of Results