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EFFECTS OF OBSERVER ON THE DIAGNOSTIC ACCURACY OF LOW-FIELD MRI FOR DETECTING CANINE MENISCAL TEARS

Authors

  • Peter Böttcher,

    Corresponding author
    • From the Department of Small Animal Medicine, University of Leipzig, Germany
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  • Laura Armbrust,

    1. Department of Clinical Sciences, Kansas State University
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Laurent Blond,

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Canada
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Andreas Brühschwein,

    1. Clinic for Surgery and Reproduction in Small Animals, Ludwig-Maximilians-University, Munich, Germany
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Patrick R. Gavin,

    1. Department of Veterinary Clinical Sciences, Washington State University
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Ingrid Gielen,

    1. Department of Medical Imaging & Small Animal Orthopaedics, Ghent University, Belgium
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Silke Hecht,

    1. Department of Small Animal Clinical Sciences, University of Tennessee
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Konrad Jurina,

    1. Tierklinik Haar, Haar, Germany
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Sibylle Kneissl,

    1. Department of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Martin Konar,

    1. MRI Support Service, Marina di Massa, Italy
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Esteban Pujol,

    1. Clinica Canis, Palma de Mallorca, Spain
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Andrew Robinson,

    1. Dovecote Veterinary Hospital, Castle Donington, UK
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  • Susan L. Schaefer,

    1. Department of Surgical Sciences, University of Wisconsin-Madison
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Lars F. H. Theyse,

    1. Department Clinical Sciences Companion Animals, Division Orthopaedics and Neurosurgery, University Utrecht, Netherlands
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Antje Wigger,

    1. Department of Veterinary Clinical Science, Clinic for Small Animal Surgery, Justus-Liebig-University Giessen, Germany
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    • These authors are listed in alphabetical order and contributed equally to the study.

  • Eberhard Ludewig

    1. From the Department of Small Animal Medicine, University of Leipzig, Germany
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Address correspondence and reprint requests to Peter Böttcher, Klinik für Kleintiere, An den Tierkliniken 23, D-04103 Leipzig, Germany. E-mail: boettcher@kleintierklinik.uni-leipzig.de

Abstract

Low-field MRI (lfMRI) has become increasingly accepted as a method for diagnosing canine meniscal tears in clinical practice. However, observer effects on diagnostic accuracy have not been previously reported. In this study, 50 consecutive stifle joints with clinical and radiologic evidence of cranial cruciate ligament insufficiency were investigated by lfMRI and arthroscopy. Fifteen observers who had varying levels of experience and who were unaware of arthroscopic findings independently reviewed lfMRI studies and recorded whether lateral and medial meniscal tears were present. Diagnostic accuracy (sensitivity, specificity, positive (PPV) and negative predictive value (NPV)) was determined for each observer and median values were calculated for all observers, using arthroscopy as the reference standard. Interrater agreement was determined based on intraclass correlation coefficient (ICC) analysis. Observer level of experience was compared with diagnostic sensitivity and specificity using correlation analysis. Based on pooled data for all observers, median sensitivity, specificity, PPV, and NPV for lfMRI diagnosis of lateral meniscal tears were 0.00, 0.94, 0.05, and 0.94, respectively. Median sensitivity, specificity, PPV, and NPV for medial meniscal tears were 0.74, 0.89, 0.83, and 0.79, respectively. Interrater agreement for all menisci was fair (0.51). Menisci were less consistently scored as having no tears (ICC = 0.13) than those scored as having tears (ICC = 0.50). No significant correlations between observer experience and diagnostic sensitivity/specificity were identified. Findings indicated that the accuracy of lfMRI for diagnosing canine meniscal tears was poor to fair and observer-dependent. Future studies are needed to develop standardized and widely accepted lfMRI criteria for diagnosing meniscal tears.

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