How to measure XXXX - a retrospective comparison of morphological measurement approaches in relation to hemodynamic significance.

@entity1 @entity20805 @entity101 @entity1347 @entity2792 @entity2791 @entity850
BACKGROUND: Although it is well known that @entity2791 may cause @entity2792 , it is unclear how the degree of @entity850 should best be measured in morphological images. The aim of this study was to determine which morphological measures from Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA) are best in predicting whether a @entity2791 is hemodynamically significant or not. METHODS: Forty-seven @entity1 with @entity101 and a clinical suspicion of @entity2792 were examined with CTA, MRA, @entity20805 -enhanced renography (CER) and @entity20805 test (Ctest). CTA and MRA images of the renal arteries were analyzed by two readers using interactive vessel segmentation software. The measures included minimum diameter, minimum area, diameter reduction and area reduction. In addition, two radiologists visually judged the diameter reduction without automated segmentation. The results were then compared using limits of agreement and intra-class correlation, and correlated with the results from CER combined with Ctest (which were used as standard of reference) using receiver operating characteristics (ROC) analysis. RESULTS: A total of 68 kidneys had all three investigations (CTA, MRA and CER   +   Ctest), where 11 kidneys (16.2  %) got a positive result on the CER   +   Ctest. The greatest area under ROC curve (AUROC) was found for the area reduction on MRA, with a value of 0.91 (95  % confidence interval 0.82-0.99), excluding accessory renal arteries. As comparison, the AUROC for the radiologists' visual assessments on CTA and MRA were 0.90 (0.82-0.98) and 0.91 (0.83-0.99) respectively. None of the differences were statistically significant. CONCLUSIONS: No significant differences were found between the morphological measures in their ability to predict hemodynamically significant @entity850 , but a tendency of MRA having higher AUROC than CTA. There was no significant difference between measurements made by the radiologists and measurements made with fuzzy @entity1347 . Further studies are required to definitely identify the optimal measurement approach.
