title: Semiquantitative assessment of cardiovascular disease markers in multislice computed tomography of the chest: interobserver and intraobserver agreements.
abstract: OBJECTIVE
  To investigate the interobserver and intraobserver agreements for the semiquantitative assessment of markers of subclinical cardiovascular disease as identified by routine care, diagnostic computed tomography (CT) of the chest, to improve the quality of reporting of these incidental findings.
  
  
  METHODS
  Two observers independently evaluated 109 consecutive chest CT scans in routine care, clinical patients from one tertiary referral center. All nongated, contrast-enhanced scans were acquired on a 16-slice CT scanner. Images were scored for the presence of aortic wall abnormalities and calcifications of the coronary artery, the heart valves, the thoracic aorta, and the proximal supraaortic arteries. Furthermore, the presence of left ventricular scarring and elongation of the aorta were recorded. All markers were scored on a semiquantitative scale. Interobserver and intraobserver agreements are presented as weighted kappa and intraclass correlation coefficients.
  
  
  RESULTS
  Interobserver and intraobserver agreements for individual markers were good to excellent, with weighted kappa coefficients of 0.54 to 0.89 for interobserver agreement and 0.55 to 0.96 for intraobserver agreement.
  
  
  CONCLUSIONS
  Semiquantitative assessment of subclinical cardiovascular disease markers in routine care, diagnostic chest CT scans is possible with good to excellent interobserver and intraobserver agreements. Use of these definitions in clinical practice will enable a more standardized assessment and reporting of incidental findings in diagnostic chest CT.
authors.affiliation: Department of Radiology, Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. p.c.a.jacobs@umcutrecht.nl
authors.forename: Peter C A
authors.initials: PC
authors.lastname: Jacobs
authors.forename: Mathias
authors.initials: M
authors.lastname: Prokop
authors.forename: Ayke L
authors.initials: AL
authors.lastname: Oen
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D013902:Radiography, Thoracic / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media