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Hematology Reports
Volume 13
Issue 3
10.4081/hr.2021.9037
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Hematology Reports is published by MDPI from Volume 14 Issue 1 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Article

Low Diagnostic Accuracy and Inter-Observer Agreement on CT and MRI in Diagnosis of Spinal Fractures in Multiple Myeloma

by
Viktor Dalen
1,
Anne-Sofie Vegsgaard Olsen
1,
Claude-Pierre Jerome
2,
Jonn-Terje Geitung
2,3 and
Anders E. A. Dahm
3,4,*
1
Medical Faculty, University of Oslo, 0315 Oslo, Norway
2
Department of Radiology, Akershus University Hospital, 1478 Lørenskog, Norway
3
Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
4
Department of Haematology, Akershus University Hospital, Lørenskog, Postbox 1000, 1478 Lørenskog, Norway
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2021, 13(3), 9037; https://doi.org/10.4081/hr.2021.9037
Submission received: 4 December 2020 / Revised: 20 April 2021 / Accepted: 10 September 2021 / Published: 4 October 2021

Abstract

Skeletal disease is common in multiple myeloma. We investigated the inter-observer agreement and diagnostic accuracy of spinal fractures diagnosed by computer tomography (CT) and magnetic resonance imaging (MRI) from 12 myeloma patients. Two radiologists independently assessed the images. CT, MRI, and other images were combined to a gold standard. The inter-observer agreement was assessed with Cohen’s kappa. Radiologist 1 diagnosed 20 malignant spinal fractures on CT and 26 on MRI, while radiologist 2 diagnosed 12 malignant spinal fractures on CT and 22 on MRI. In comparison the gold standard diagnosed 10 malignant spinal fractures. The sensitivity for malignant fractures varied from 0.5 to 1 for CT and MRI, and the specificity varied from 0.17 to 0.67. On MRI, the specificity for malignant spinal fractures was 0.17 for both radiologists. The inter-observer agreement for malignant spinal fractures on CT was −0.42 (Cohen’s kappa) and −0.13 for MRI, while for osteoporotic fractures it was −0.24 for CT and 0.53 for MRI. We conclude that malignant spinal fractures were over-diagnosed on CT and MRI. The inter-observer agreement was extremely poor.
Keywords: diagnostic specificity; malignant fractures; osteoporotic fractures; diagnostic imaging; haematology; multiple myeloma diagnostic specificity; malignant fractures; osteoporotic fractures; diagnostic imaging; haematology; multiple myeloma

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MDPI and ACS Style

Dalen, V.; Vegsgaard Olsen, A.-S.; Jerome, C.-P.; Geitung, J.-T.; Dahm, A.E.A. Low Diagnostic Accuracy and Inter-Observer Agreement on CT and MRI in Diagnosis of Spinal Fractures in Multiple Myeloma. Hematol. Rep. 2021, 13, 9037. https://doi.org/10.4081/hr.2021.9037

AMA Style

Dalen V, Vegsgaard Olsen A-S, Jerome C-P, Geitung J-T, Dahm AEA. Low Diagnostic Accuracy and Inter-Observer Agreement on CT and MRI in Diagnosis of Spinal Fractures in Multiple Myeloma. Hematology Reports. 2021; 13(3):9037. https://doi.org/10.4081/hr.2021.9037

Chicago/Turabian Style

Dalen, Viktor, Anne-Sofie Vegsgaard Olsen, Claude-Pierre Jerome, Jonn-Terje Geitung, and Anders E. A. Dahm. 2021. "Low Diagnostic Accuracy and Inter-Observer Agreement on CT and MRI in Diagnosis of Spinal Fractures in Multiple Myeloma" Hematology Reports 13, no. 3: 9037. https://doi.org/10.4081/hr.2021.9037

APA Style

Dalen, V., Vegsgaard Olsen, A. -S., Jerome, C. -P., Geitung, J. -T., & Dahm, A. E. A. (2021). Low Diagnostic Accuracy and Inter-Observer Agreement on CT and MRI in Diagnosis of Spinal Fractures in Multiple Myeloma. Hematology Reports, 13(3), 9037. https://doi.org/10.4081/hr.2021.9037

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