PDF(Pubmed)
Abstract：
UNASSIGNED: MRI is an emerging imaging modality to assess skeletal maturity. This study aimed to chart the learning curves of paediatric radiologists when using an unfamiliar MRI grading system of skeletal maturity and to assess the clinical feasibility of implementing said system.
UNASSIGNED: 958 healthy paediatric volunteers were prospectively included in a dual-facility study. Each subject underwent a conventional MRI scan at 1.5 T. To perform the image reading, the participants were grouped into five subsets (subsets 1-5) of equal size (n∼192) in chronological order for scan acquisition. Two paediatric radiologists (R1-2) with different levels of MRI experience, both of whom were previously unfamiliar with the study\'s MRI grading system, independently evaluated the subsets to assess skeletal maturity in five different growth plate locations. Congruent cases at blinded reading established the consensus reading. For discrepant cases, the consensus reading was obtained through an unblinded reading by a third paediatric radiologist (R3), also unfamiliar with the MRI grading system. Further, R1 performed a second blinded image reading for all included subjects with a memory wash-out of 180 days. Weighted Cohen kappa was used to assess interreader reliability (R1 vs consensus; R2 vs consensus) at non-cumulative and cumulative time points, as well as interreader (R1 vs R2) and intrareader (R1 vs R1) reliability at non-cumulative time points.
UNASSIGNED: Mean weighted Cohen kappa values for each pair of blinded readers compared to consensus reading (interreader reliability, R1-2 vs consensus) were ≥0.85, showing a strong to almost perfect interreader agreement at both non-cumulative and cumulative time points and in all growth plate locations. Weighted Cohen kappa values for interreader (R1 vs R2) and intrareader reliability (R1 vs R1) were ≥0.72 at non-cumulative time points, with values ≥0.82 at subset 5.
UNASSIGNED: Paediatric radiologists\' clinical confidence when introduced to a new MRI grading system for skeletal maturity was high from the outset of their learning curve, despite the radiologists\' varying levels of work experience with MRI assessment. The MRI grading system for skeletal maturity investigated in this study is a robust clinical method when used by paediatric radiologists and can be used in clinical practice.
UNASSIGNED: Radiologists with fellowship training in paediatric radiology experienced no learning curve progress when introduced to a new MRI grading system for skeletal maturity and achieved desirable agreement from the first time point of the learning curve. The robustness of the investigated MRI grading system was not affected by the earlier different levels of MRI experience among the readers.
UNASSIGNED: 958 healthy paediatric volunteers were prospectively included in a dual-facility study. Each subject underwent a conventional MRI scan at 1.5 T. To perform the image reading, the participants were grouped into five subsets (subsets 1-5) of equal size (n∼192) in chronological order for scan acquisition. Two paediatric radiologists (R1-2) with different levels of MRI experience, both of whom were previously unfamiliar with the study\'s MRI grading system, independently evaluated the subsets to assess skeletal maturity in five different growth plate locations. Congruent cases at blinded reading established the consensus reading. For discrepant cases, the consensus reading was obtained through an unblinded reading by a third paediatric radiologist (R3), also unfamiliar with the MRI grading system. Further, R1 performed a second blinded image reading for all included subjects with a memory wash-out of 180 days. Weighted Cohen kappa was used to assess interreader reliability (R1 vs consensus; R2 vs consensus) at non-cumulative and cumulative time points, as well as interreader (R1 vs R2) and intrareader (R1 vs R1) reliability at non-cumulative time points.
UNASSIGNED: Mean weighted Cohen kappa values for each pair of blinded readers compared to consensus reading (interreader reliability, R1-2 vs consensus) were ≥0.85, showing a strong to almost perfect interreader agreement at both non-cumulative and cumulative time points and in all growth plate locations. Weighted Cohen kappa values for interreader (R1 vs R2) and intrareader reliability (R1 vs R1) were ≥0.72 at non-cumulative time points, with values ≥0.82 at subset 5.
UNASSIGNED: Paediatric radiologists\' clinical confidence when introduced to a new MRI grading system for skeletal maturity was high from the outset of their learning curve, despite the radiologists\' varying levels of work experience with MRI assessment. The MRI grading system for skeletal maturity investigated in this study is a robust clinical method when used by paediatric radiologists and can be used in clinical practice.
UNASSIGNED: Radiologists with fellowship training in paediatric radiology experienced no learning curve progress when introduced to a new MRI grading system for skeletal maturity and achieved desirable agreement from the first time point of the learning curve. The robustness of the investigated MRI grading system was not affected by the earlier different levels of MRI experience among the readers.
摘要：
■MRI是评估骨骼成熟度的新兴成像方式。这项研究旨在绘制儿科放射科医生在使用不熟悉的MRI骨骼成熟度分级系统时的学习曲线，并评估实施该系统的临床可行性。
■958名健康的儿科志愿者被前瞻性地纳入了一项双重设施研究。每位受试者在1.5T进行常规MRI扫描以进行图像读取，按时间顺序将参与者分为5个大小相等(n~192)的子集(子集1-5)进行扫描采集.两名儿科放射科医师（R1-2）具有不同程度的MRI经验，两人以前都不熟悉这项研究的MRI分级系统，独立评估子集，以评估五个不同生长板位置的骨骼成熟度。盲读中的一致案例建立了共识阅读。对于不一致的情况，共识读数是通过第三位儿科放射科医生（R3）的非盲读数获得的，也不熟悉MRI分级系统。Further,R1对所有包含的受试者进行了第二次盲化图像读取，记忆消失了180天。加权Cohenkappa用于评估非累积和累积时间点的读者间可靠性（R1vs共识；R2vs共识），以及非累积时间点的互读（R1vsR2）和内（R1vsR1）可靠性。
■与共识阅读相比，每对盲人读者的平均加权Cohenkappa值（互读可靠性，R1-2与共识）≥0.85，在非累积和累积时间点以及所有生长板位置均显示出强至几乎完美的相互一致性。在非累积时间点，对讲机（R1vsR2）和内部可靠性（R1vsR1）的加权Cohenkappa值≥0.72，子集5的值≥0.82。
儿科放射科医师在引入新的MRI骨骼成熟度分级系统时，从学习曲线开始就很高，尽管放射科医生在MRI评估方面的工作经验不同。本研究中研究的骨骼成熟度MRI分级系统是儿科放射科医生使用的一种可靠的临床方法，可用于临床实践。
■接受儿科放射学研究金培训的放射科医师在引入新的MRI骨骼成熟度分级系统时没有学习曲线进展，并且从学习曲线的第一个时间点就取得了理想的一致性。所研究的MRI分级系统的鲁棒性不受读者早期不同程度的MRI经验的影响。
■958名健康的儿科志愿者被前瞻性地纳入了一项双重设施研究。每位受试者在1.5T进行常规MRI扫描以进行图像读取，按时间顺序将参与者分为5个大小相等(n~192)的子集(子集1-5)进行扫描采集.两名儿科放射科医师（R1-2）具有不同程度的MRI经验，两人以前都不熟悉这项研究的MRI分级系统，独立评估子集，以评估五个不同生长板位置的骨骼成熟度。盲读中的一致案例建立了共识阅读。对于不一致的情况，共识读数是通过第三位儿科放射科医生（R3）的非盲读数获得的，也不熟悉MRI分级系统。Further,R1对所有包含的受试者进行了第二次盲化图像读取，记忆消失了180天。加权Cohenkappa用于评估非累积和累积时间点的读者间可靠性（R1vs共识；R2vs共识），以及非累积时间点的互读（R1vsR2）和内（R1vsR1）可靠性。
■与共识阅读相比，每对盲人读者的平均加权Cohenkappa值（互读可靠性，R1-2与共识）≥0.85，在非累积和累积时间点以及所有生长板位置均显示出强至几乎完美的相互一致性。在非累积时间点，对讲机（R1vsR2）和内部可靠性（R1vsR1）的加权Cohenkappa值≥0.72，子集5的值≥0.82。
儿科放射科医师在引入新的MRI骨骼成熟度分级系统时，从学习曲线开始就很高，尽管放射科医生在MRI评估方面的工作经验不同。本研究中研究的骨骼成熟度MRI分级系统是儿科放射科医生使用的一种可靠的临床方法，可用于临床实践。
■接受儿科放射学研究金培训的放射科医师在引入新的MRI骨骼成熟度分级系统时没有学习曲线进展，并且从学习曲线的第一个时间点就取得了理想的一致性。所研究的MRI分级系统的鲁棒性不受读者早期不同程度的MRI经验的影响。
