Intra- and inter-rater reliability in a comparative study of cross-sectional and spiral computed tomography pelvimetry methods

Background Different low-dose computed tomography (CT) pelvimetry methods can be used to evaluate the size of birth canal before delivery. CT pelvimetry might generate an acceptable low fetal radiation dose but its measurement accuracy is unknown. Purpose To investigate intra- and inter-rater measur...

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Bibliographic Details
Published in:	Acta radiologica open Vol. 8; no. 6; p. 2058460119855187
Main Authors:	Phexell, Erika, Åkesson, Anna, Söderberg, Marcus, Bolejko, Anetta
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-06-2019 Sage Publications Ltd
Subjects:	Abdomen Body mass Body mass index Body size Clinical Medicine Comparative studies Computed tomography Confidence intervals Correlation analysis Correlation coefficient Correlation coefficients Fetuses Klinisk medicin Medical and Health Sciences Medical imaging Medicin och hälsovetenskap Methods Pelvis Radiation Radiation dosage Radiation measurement Radiologi och bildbehandling Radiology, Nuclear Medicine and Medical Imaging Reliability analysis Tomography Pelvimetry intra-rater reliability computed tomography spiral inter-rater reliability
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Summary:	Background Different low-dose computed tomography (CT) pelvimetry methods can be used to evaluate the size of birth canal before delivery. CT pelvimetry might generate an acceptable low fetal radiation dose but its measurement accuracy is unknown. Purpose To investigate intra- and inter-rater measurement reliability of cross-sectional and two spiral CT pelvimetry methods: standard spiral and short spiral. Material and Methods Ten individuals (age ≥60 years, body mass index ≥30 kg/m2) having a CT scan of the abdomen also had CT pelvimetry scans. Three radiologists made independent measurements of each pelvimetry method on two occasions and also in consensus for a reference pelvimetry computed from the standard-dose CT scan of the abdomen. Inter- and intra-rater reliability was analyzed by intraclass correlation coefficient. Results Measurements in the short spiral pelvimetry demonstrated excellent intra- and inter-rater reliability, intraclass correlation coefficient ≥0.93, and good to excellent 95% confidence interval 0.87–0.99. Corresponding results of the standard spiral and cross-sectional pelvimetry showed good to excellent intraclass correlation coefficient ≥0.85 and ≥0.76, and 95% confidence interval was least good and moderate 0.73–0.98 and 0.59–0.97, respectively. Intraclass correlation coefficient between reference pelvimetry and other CT methods showed analogous results. Conclusion The short spiral pelvimetry demonstrated high and best reliability in comparison to other methods. Standard spiral method showed also good measurement reliability but the short spiral pelvimetry generates lower fetal radiation dose. This method might be suitable for measurements at narrow pelvis. Patient acceptance and attitude to CT pelvimetry should be investigated.
ISSN:	2058-4601 2058-4601
DOI:	10.1177/2058460119855187