title: Influence of nomenclature in the interpretation of lumbar disk contour on MR imaging: a comparison of the agreement using the combined task force and the nordic nomenclatures.
abstract: OBJECTIVE
  The CTF nomenclature had not been tested in clinical practice. The purpose of this study was to compare the reliability and diagnostic confidence in the interpretation of disk contours on lumbar 1.5T MR imaging when using the CTF and the Nordic nomenclatures.
  
  
  METHODS
  Five general radiologists from 3 hospitals blindly and independently assessed intravertebral herniations (Schmorl node) and disk contours on the lumbar MR imaging of 53 patients with low back pain, on 4 occasions. Measures were taken to minimize the risk of recall bias. The Nordic nomenclature was used for the first 2 assessments, and the CTF nomenclature, in the remaining 2. Radiologists had not previously used either of the 2 nomenclatures. κ statistics were calculated separately for reports deriving from each nomenclature and were categorized as almost perfect (0.81-1.00), substantial (0.61-0.80), moderate (0.41-0.60), fair (0.21-0.40), slight (0.00-0.20), and poor (<0.00).
  
  
  RESULTS
  Categorization of intra- and interobserver agreement was the same across nomenclatures. Intraobserver reliability was substantial for intravertebral herniations and disk contour abnormalities. Interobserver reliability was moderate for intravertebral herniations and fair to moderate for disk contour.
  
  
  CONCLUSIONS
  In conditions close to clinical practice, regardless of the specific nomenclature used, a standardized nomenclature supports only moderate interobserver agreement. The Nordic nomenclature increases self-confidence in an individual observer's report but is less clear regarding the classification of disks as normal versus bulged.
authors.affiliation: Department of Radiology, Fundación Instituto Valenciano de Oncología, Valencia, Spain. aranae@uv.es
authors.forename: E
authors.initials: E
authors.lastname: Arana
authors.forename: F M
authors.initials: FM
authors.lastname: Kovacs
authors.forename: A
authors.initials: A
authors.lastname: Royuela
authors.forename: A
authors.initials: A
authors.lastname: Estremera
authors.forename: H
authors.initials: H
authors.lastname: Sarasíbar
authors.forename: G
authors.initials: G
authors.lastname: Amengual
authors.forename: I
authors.initials: I
authors.lastname: Galarraga
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.forename: A
authors.initials: A
authors.lastname: Muriel
authors.forename: V
authors.initials: V
authors.lastname: Abraira
authors.forename: J
authors.initials: J
authors.lastname: Zamora
authors.forename: C
authors.initials: C
authors.lastname: Campillo
mesh_terms: D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology* / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000473:pathology; D007558:Italy / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity