Related Experiment Video
Updated: Feb 5, 2026
10:50
Primary Culture of Human Vestibular Schwannomas
Published on: July 20, 2014
13.4K
Koos Classification of Vestibular Schwannomas: A Reliability Study
Nicholas J Erickson1, Philip G R Schmalz1, Bonita S Agee1
1Department of Neurological Surgery, the University of Alabama at Birmingham, Birmingham, Alabama.
Neurosurgery
|September 1, 2018
Summary
The Koos classification system for vestibular schwannoma demonstrates high reliability among raters for stratifying tumors. This study confirms its consistency in grading vestibular schwannomas, supporting its clinical use.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- The Koos classification stratifies vestibular schwannomas by tumor extension and brainstem compression.
- Despite widespread use, the reliability of the Koos classification has not been previously assessed.
Purpose of the Study:
- To evaluate the intra- and inter-rater reliability of the Koos classification system for vestibular schwannomas.
Main Methods:
- 40 MRI scans of vestibular schwannomas were reviewed by 4 raters.
- Koos grades were assigned, and reliability was calculated using Fleiss' kappa, Kendall's W, and ICC.
Main Results:
- Inter-rater reliability was substantial to excellent (kappa .71, W .92, ICC .88).
- Intra-rater reliability was perfect or extremely high for all 4 raters.
Conclusions:
- The Koos classification system for vestibular schwannoma is a reliable method for tumor stratification.
- This study supports the consistent application of the Koos grading system in clinical practice and research.
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