title: Reproducibility of the SPI-US protocol for ultrasound diameter measurements of the Posterior Circumflex Humeral Artery and Deep Brachial Artery: an inter-rater reliability study.
abstract: OBJECTIVE
  Elite overhead athletes are at risk of posterior circumflex humeral artery (PCHA) degeneration, aneurysm formation and thrombosis. Identification of the proximal PCHA and the nearby originating deep brachial artery (DBA) can be a challenge, even among experienced sonographers. The aim of this study was to assess the accuracy and precision of a newly designed standardized ultrasound (US) protocol (SPI-US) for assessment of the PCHA and DBA.
  
  
  METHODS
  Two experienced sonographers determined diameters of the PCHA and DBA using the SPI-US protocol. Inter-observer agreement was evaluated using intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), Bland-Altman (BA) analysis, and variance component (VARCOMP) analysis.
  
  
  RESULTS
  Thirty-three healthy volunteers participated. The ICC for diameter measurement of the PCHA and DBA were 0.70 (95 %CI 0.50-0.83) and 0.60 (95 %CI 0.30-0.80), respectively. The SEM for the PCHA and DBA was 0.32 mm and 0.29 mm and MDC was 0.90 mm and 0.80 mm, respectively. The BA and VARCOMP analyses showed no systematic and only marginal sonographer bias.
  
  
  CONCLUSIONS
  The SPI-US protocol is accurate and precise for PCHA and DBA diameter assessment in cases where they originate from the axillary artery. PCHA and DBA diameter measurements are sonographer-independent using the SPI-US-protocol.
  
  
  CONCLUSIONS
  • PCHA & DBA diameter assessment is accurate and reliable using the SPI-US protocol • PCHA & DBA diameter measurements are sonographer-independent using the SPI-US protocol • The SPI-US protocol minimal detectable change is 0.90 mm for PCHA diameter measurement • This minimal detectable change enables detection of PCHA aneurysms • First step towards international periodic surveillance of athletes at risk of PCHA-injury.
authors.affiliation: Department of Radiology, Academic Medical Center/University of Amsterdam, PO Box 22700, NL-1100 DE, Amsterdam, The Netherlands. daanvandepol@gmail.com.
authors.forename: Daan
authors.initials: D
authors.lastname: van de Pol
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Sena
authors.initials: S
authors.lastname: Alaeikhanehshir
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: P Paul F M
authors.initials: PP
authors.lastname: Kuijer
authors.affiliation: Department of Radiology, Academic Medical Center/University of Amsterdam, PO Box 22700, NL-1100 DE, Amsterdam, The Netherlands.
authors.forename: Aart
authors.initials: A
authors.lastname: Terpstra
authors.affiliation: Department of Radiology, Academic Medical Center/University of Amsterdam, PO Box 22700, NL-1100 DE, Amsterdam, The Netherlands.
authors.forename: Marja J C
authors.initials: MJ
authors.lastname: Pannekoek-Hekman
authors.affiliation: Department of Radiology, Academic Medical Center/University of Amsterdam, PO Box 22700, NL-1100 DE, Amsterdam, The Netherlands.
authors.forename: R Nils
authors.initials: RN
authors.lastname: Planken
authors.affiliation: Department of Radiology, Academic Medical Center/University of Amsterdam, PO Box 22700, NL-1100 DE, Amsterdam, The Netherlands.
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000783:Aneurysm / Q000000981:diagnostic imaging; D001158:Arteries / Q000000981:diagnostic imaging; D001265:Athletic Injuries / Q000000981:diagnostic imaging*; D001916:Brachial Artery / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006811:Humerus / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D013927:Thrombosis / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods*; D054798:Volleyball / Q000293:injuries; D055815:Young Adult
keywords: Aeliability; Aneurysm; Posterior circumflex humeral artery; Ultrasound; Volleyball