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Reliability of fast-spin echo T2-weighted three-dimensional sequences to predict endoscopic third
Etienne Lefevre1,2, Yohan Caudron3,4, Kevin Beccaria5,6
1Department of Neurosurgery - Pitié-Salpêtrière Hospital, Paris, France.
Insights
3D fast-spin echo T2-weighted sequences accurately assess endoscopic third ventriculocisternostomy (ETV) patency in children. This reproducible tool demonstrates excellent interrater reliability, making it suitable for daily clinical practice.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Medical Imaging
Background:
- Assessing the patency of endoscopic third ventriculocisternostomy (ETV) in pediatric patients presents clinical and radiological challenges.
- Reliable methods are needed to evaluate ETV function post-surgery.
Purpose of the Study:
- To evaluate the accuracy and interrater reliability of 3D fast-spin echo (FSE) T2-weighted sequences for determining ETV patency in children.
Main Methods:
- A retrospective study included children who underwent ETV surgery, comparing those with dysfunction to a matched control group without dysfunction.
- Three experienced physicians assessed ETV patency using the flow void sign on 3D FSE T2-weighted sequences.
- Interrater reliability was calculated using Fleiss' kappa.
Main Results:
- The study analyzed 19 children with ETV dysfunction and 12 matched controls.
- Sensitivity ranged from 0.79 to 0.89, and specificity was 1 for all raters.
- Fleiss' kappa was 0.871 (p < 0.001), indicating excellent interrater reliability for assessing ETV patency.
Conclusions:
- 3D FSE T2-weighted sequences are a simple, reproducible tool for assessing ETV patency in pediatric patients.
- The sequence offers high interrater reliability and is accessible for outpatient use.
- This imaging technique can be widely adopted in routine clinical practice.
Purpose:
Clinical and radiological assessment of endoscopic third ventriculocisternostomy (ETV) patency can be challenging in children. The objective of our study was thus to test the accuracy and interrater reliability of 3D fast-spin echo (FSE) T2-weighted sequences to assess the patency of ETV.
Methods:
We included all the consecutive children who underwent surgery for ETV over a two-year period and selected the children who presented ETV dysfunction and matched them with children without dysfunction. We evaluated the Kappa interrater reliability of three experienced physicians for prediction of ETV patency using solely the flow void sign in 3D FSE T2-weighted sequences.
Results:
Nineteen children underwent surgery for ETV dysfunction and 12 children without dysfunction were matched. Sensitivity was 0.79, 0.89 and 0.84 and specificity was 1 for all raters. None of the patent ETV was wrongly considered to be dysfunctional. Fleiss' kappa was 0.871 (p < 0.001). The interrater reliability was excellent with respect to the patency or not of the ETV.
Conclusion:
FSE T2-weighted sequence is a simple and reproducible tool that can be widely used in daily practice to assess the patency of ETV. Interrater reliability of this sequence is high and accessibility in outpatient setting is acceptable.
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