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Reliability of the global cortical atrophy visual rating scale applied to computed tomography versus magnetic resonance imaging scans in acute stroke

Abstract:

Introduction: Research using magnetic resonance imaging (MRI) suggests regional cerebral atrophy measures (e.g., frontal lobe, temporal lobe) may predict post-stroke outcomes. Clinical CT scans have excellent potential for use in research but it is unclear whether regional atrophy measures from CT are reliable compared to MRI reference standards.

Methods: We used the Global Cortical Atrophy (GCA) scale to investigate reliability of atrophy measures on CT versus MRI scans from stroke patients originally recruited to the Oxford Cognitive Screening programme. Two raters provided standardised visual ratings at two timepoints. Weighted Kappa statistics assessed the reliability of regional atrophy scores. Spearman’s correlation and a two-way repeated measures ANOVA assessed the reliability of the total score.

Results: On clinically acquired neuroimaging from 98 stroke patients (mean/SD age = 70.97/11.99, 42 female, 84 ischaemic stroke), regional GCA scores on CT versus MRI showed fair to almost perfect intra-rater agreement (κ = .50–.87), substantial to almost perfect intra-rater agreement on CT (κ = .67–.88), and moderate to almost perfect intra-rater reliability on MRI (κ = .50–.89). Regional GCA scores showed mostly moderate to substantial inter-rater reliability on both CT and MRI (κ = .43–.69), except the temporal horns and parieto-occipital region. There was a strong correlation between total GCA scores on CT and MRI (r (96) = .87–.88, p < .001).

Conclusions: These results support the use of cerebral atrophy measures from CT in clinical research, as visual ratings showed generally good agreement between CT and MRI, between raters, and between timepoints.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s10072-023-07113-z

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Experimental Psychology
Role:
Author
ORCID:
0000-0002-4443-296X
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Experimental Psychology
Role:
Author
ORCID:
0000-0003-0416-5147


More from this funder
Funder identifier:
https://ror.org/0187kwz08
Grant:
NIHR RCF 21/040


Publisher:
Springer
Journal:
Neurological Sciences More from this journal
Volume:
45
Issue:
4
Pages:
1549-1556
Publication date:
2023-11-01
Acceptance date:
2023-10-01
DOI:
EISSN:
1590-3478
ISSN:
1590-1874
Pmid:
37910322


Language:
English
Keywords:
Pubs id:
1560693
Local pid:
pubs:1560693
Deposit date:
2025-04-23
ARK identifier:

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