Carotid Plaque Characteristics Evaluation on DUS and MDCTA: Interobserver and Intermodality Agreement in a...

Area of Science:

• Vascular Imaging and Diagnostics
• Cerebrovascular Disease Assessment
• Medical Imaging Reproducibility

Background:

• Carotid artery stenosis evaluation traditionally relies on luminal narrowing.
• Plaque morphology and composition are emerging as critical indicators of cerebrovascular risk.
• Reproducibility in plaque characterization is vital for consistent clinical decision-making.

Purpose of the Study:

• To evaluate interobserver agreement in carotid plaque assessment using multidetector computed tomography angiography (MDCTA).
• To assess intermodality agreement between MDCTA and duplex ultrasonography (DUS).

Main Methods:

• 50 patients with ≥60% internal carotid artery stenosis underwent MDCTA and DUS.
• Two radiologists independently analyzed MDCTA for plaque composition, surface, stenosis, and length.
• A third observer evaluated DUS.
• Interobserver and intermodality agreement calculated using Cohen's kappa coefficient.

Main Results:

• Good interobserver agreement for MDCTA (κ = 0.751).
• Moderate intermodality agreement between MDCTA and DUS (κ = 0.624, 0.595).
• DUS showed significantly higher stenosis values and plaque length compared to MDCTA.

Conclusions:

• MDCTA offers good interobserver reproducibility for carotid plaque characterization.
• Intermodality agreement between MDCTA and DUS is moderate.
• Clinical decisions require consideration of systematic differences in stenosis grading and plaque surface evaluation between modalities.