Inter-observer variability for detection of suspected ileocolonic Crohn's disease with magnetic resonance...

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Magnetic resonance enterography (MRE) is a key imaging modality for visualizing Crohn's disease (CD) and its complications.
• Accurate assessment of CD, particularly in the ileocolonic region, is crucial for diagnosis and management.

Purpose of the Study:

• To evaluate the inter-observer agreement among radiologists in detecting and assessing ileocolonic Crohn's disease using MRE.
• To compare the agreement levels between senior radiologists and junior doctors in training.

Main Methods:

• A post-hoc analysis of MRE scans from 48 patients with suspected CD was performed.
• Two senior radiologists and two junior doctors independently assessed MREs for image quality, CD presence, and disease severity, blinded to clinical data.
• Inter-observer agreement was quantified using Kappa statistics for CD detection and Intraclass Correlation Coefficients (ICCs) for disease severity scoring.

Main Results:

• Inter-observer agreement for CD detection was moderate to substantial across the ileocolon (κ=0.65), terminal ileum (κ=0.77), and colon (κ=0.59).
• Agreement was generally higher among senior radiologists compared to junior doctors, although not statistically significant.
• Inter-observer agreement for disease severity scoring (MaRIA and simplified MaRIA) was poor to moderate (ICC=0.51 and 0.46, respectively), with senior radiologists showing better consistency.

Conclusions:

• MRE demonstrates moderate to substantial inter-observer agreement for ileocolonic CD evaluation in early disease stages.
• Lower agreement in colonic assessment may be attributed to the challenges of detecting early-stage disease rather than observer variability.
• Complementary assessment methods may be necessary to optimize the evaluation of colonic involvement in CD.