TY - JOUR
T1 - Neuropathy Score Reporting and Data System
T2 - A Reporting Guideline for MRI of Peripheral Neuropathy With a Multicenter Validation Study
AU - Chhabra, Avneesh
AU - Deshmukh, Swati D.
AU - Lutz, Amelie M.
AU - Fritz, Jan
AU - Andreisek, Gustav
AU - Sneag, Darryl B.
AU - Subhawong, Ty
AU - Singer, Adam D.
AU - Wong, Philip K.
AU - Thakur, Uma
AU - Pandey, Tarun
AU - Chalian, Majid
AU - Mogharrabi, Bayan N.
AU - Guirguis, Mina
AU - Xi, Yin
AU - Ahlawat, Shivani
AU - Nacey, Nicholas C.
AU - Budovec, Joseph J.
AU - Mautz, Alan
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2022/8
Y1 - 2022/8
N2 - BACKGROUND. A standardized guideline and scoring system would improve evaluation and reporting of peripheral neuropathy (PN) on MRI. OBJECTIVE. The objective of this study was to create and validate a neuropathy classification and grading system, which we named the Neuropathy Score Reporting and Data System (NS-RADS). METHODS. This retrospective study included 100 patients with nerve imaging studies and known clinical diagnoses. Experts crafted NS-RADS using mutually agreed-on qualitative criteria for the classification and grading of PN. Different classes were created to account for the spectrum of underlying pathologies: unremarkable (U), injury (I), neoplasia (N), entrapment (E), diffuse neuropathy (D), not otherwise specified (NOS), and postintervention state (PI). Subclasses were established to describe the severity or extent of the lesions. Validation testing was performed by 11 readers from 10 institutions with experience levels ranging from 3 to 18 years after residency. After initial reader training, cases were presented to readers who were blinded to the final clinical diagnoses. Interobserver agreement was assessed using correlation coefficients and the Conger kappa, and accuracy testing was performed. RESULTS. Final clinical diagnoses included normal (n = 5), nerve injury (n = 25), entrapment (n = 15), neoplasia (n = 33), diffuse neuropathy (n = 18), and persistent neuropathy after intervention (n = 4). The miscategorization rate for NS-RADS classes was 1.8%. Final diagnoses were correctly identified by readers in 71–88% of cases. Excellent interreader agreement was found on the NS-RADS pathology categorization (κ = 0.96; 95% CI, 0.93–0.98) as well as muscle pathology categorization (κ = 0.76; 95% CI, 0.68–0.82). The accuracy for determining milder versus more severe categories per radiologist ranged from 88% to 97% for nerve lesions and from 86% to 94% for muscle abnormalities. CONCLUSION. The proposed NS-RADS classification is accurate and reliable across different reader experience levels and a spectrum of PN conditions.
AB - BACKGROUND. A standardized guideline and scoring system would improve evaluation and reporting of peripheral neuropathy (PN) on MRI. OBJECTIVE. The objective of this study was to create and validate a neuropathy classification and grading system, which we named the Neuropathy Score Reporting and Data System (NS-RADS). METHODS. This retrospective study included 100 patients with nerve imaging studies and known clinical diagnoses. Experts crafted NS-RADS using mutually agreed-on qualitative criteria for the classification and grading of PN. Different classes were created to account for the spectrum of underlying pathologies: unremarkable (U), injury (I), neoplasia (N), entrapment (E), diffuse neuropathy (D), not otherwise specified (NOS), and postintervention state (PI). Subclasses were established to describe the severity or extent of the lesions. Validation testing was performed by 11 readers from 10 institutions with experience levels ranging from 3 to 18 years after residency. After initial reader training, cases were presented to readers who were blinded to the final clinical diagnoses. Interobserver agreement was assessed using correlation coefficients and the Conger kappa, and accuracy testing was performed. RESULTS. Final clinical diagnoses included normal (n = 5), nerve injury (n = 25), entrapment (n = 15), neoplasia (n = 33), diffuse neuropathy (n = 18), and persistent neuropathy after intervention (n = 4). The miscategorization rate for NS-RADS classes was 1.8%. Final diagnoses were correctly identified by readers in 71–88% of cases. Excellent interreader agreement was found on the NS-RADS pathology categorization (κ = 0.96; 95% CI, 0.93–0.98) as well as muscle pathology categorization (κ = 0.76; 95% CI, 0.68–0.82). The accuracy for determining milder versus more severe categories per radiologist ranged from 88% to 97% for nerve lesions and from 86% to 94% for muscle abnormalities. CONCLUSION. The proposed NS-RADS classification is accurate and reliable across different reader experience levels and a spectrum of PN conditions.
KW - MRI
KW - NS-RADS
KW - neuritis
KW - neuropathy score
KW - peripheral neuropathy
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U2 - 10.2214/AJR.22.27422
DO - 10.2214/AJR.22.27422
M3 - Article
C2 - 35234483
AN - SCOPUS:85128843416
SN - 0361-803X
VL - 219
SP - 279
EP - 291
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 2
ER -