Inverted grayscale in hand X-rays in patients with rheumatoid arthritis: A pilot study/ Romatoid artritli hastalarda duz el grafisi cekimlerinde ters gri tonlama yontemi: Pilot calisma

• Published in: Journal of Turkish Society for Rheumatology Vol. 15; no. 2; p. 102
• Main Authors: Erdogan, Mustafa, Ozturk, Adil, Yurttas, Berna, Icacan, Ozan Cemal, Bes, Cemal
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.07.2023
• Subjects: Care and treatment; Clinics; Comparative analysis; Osteoarthritis; Rheumatoid factor; X-rays
• ISSN: 2651-2653
• DOI: 10.4274/raed.galenos.2023.80774

Objective: To test the evaluability of inverted grayscale (IGS), a digital editing method on plain X-ray images, in diagnosing rheumatoid arthritis (RA). Methods: Standard and IGS views of X-rays of 15 patients who were randomly selected among patients with RA or suspected inflammatory arthropathy who applied to our outpatient clinic consecutively between June 2020 and September 2022, were evaluated by 3 rheumatology specialists with at least 2 years of rheumatology experience. The presence of findings of RA and osteoarthritis (OA) and how confident they were in their decisions were assessed. The evaluations of the rheumatologists were compared with the evaluation of the radiologist, and the inter-rater agreement was calculated with the Cohen Kappa (CK) test. Inter-rater agreement according to the coefficient of variation obtained with the CK test was defined as; <0.20: no agreement, 0.21 0.40: poor agreement, 0.41-0.60: moderate agreement, 0.61-0.80: good agreement, 0.80-1: excellent agreement. Results: In evaluating images of patients with RA, a low-moderate agreement was found between the raters. While the agreement level of less experienced specialists for IGS and standard view differed, the agreement level of the more experienced rheumatologist was similar for TGT and standard views. The Likert scale score, which expresses how confident the evaluators are in their decisions, was high for all researchers. Conclusion: IGS is a method that rheumatologists can easily evaluate. However, large-scale studies are needed to evaluate the additional contribution of IGS in detecting RA findings, especially by less experienced specialists. Keywords: Rheumatoid arthritis, diagnostic imaging, digital radiography Amaci Bu calismanin amaci romatoid artrit (RA) tanisinda duz grafi goruntuleri uzerinde yapilan dijital duzenleme yontemi olan ters gri tonlamanin (TGT) degerlendirilebilirligini test etmektir. Yontemi RA tanisi olan veya enflamatuvar artropati suphesi ile 2020 Haziran ve 2022 Eylul tarihleri arasinda poliklinigimize ardisik olarak basvuran, el on-arka standart eklem grafisi (X-ray) cekilmis hastalar arasindan rastgele secilmis 15 hastaya ait el grafilerinin standart ve TGT gorunumleri en az 2 yil romatoloji tecrubesine sahip 3 romatoloji uzmani tarafindan degerlendirildi. RA ve osteoartrit bulgularinin varligi ve kararlarindan ne kadar emin olduklari Likert olcegi ile sorgulandi. Romatoloji uzmanlarinin degerlendirmeleri radyoloji uzmaninin degerlendirmesi ile kiyaslanarak degerlendiriciler arasi uyum Cohen Kappa (CK) testi ile hesaplandi. CK testi ile elde edilen degiskenlik kat sayisina gore degerlendiriciler arasi uyum; <0,20: uyum yok, 0,210,40: zayif uyum, 0,41-0,60: orta uyum, 0,61-0,80: iyi uyum, 0,80-1: cok iyi uyum olarak kabul edildi. Bulgular: RA'li hasta goruntulerinin degerlendirmesinde, degerlendirmeciler arasinda dusuk-orta derecede uyum saptandi. Daha az tecrubeye sahip uzmanlarin TGT goruntuleri icin yaptiklari degerlendirmeler farklilik gosterirken, daha tecrubeli romatoloji uzmaninin TGT ve standart goruntu degerlendirme icin radyologla uyumu benzer duzeyde saptanmistir. Degerlendirmecilerin verdikleri kararlarindan ne kadar emin oldugunu ifade eden Likert olcegi skoru tum arastirmacilar icin yuksek saptanmistir. Sonuc: TGT romatoloji uzmanlari tarafindan kolay degerlendirilebilir bir yontemdir. Ancak, TGT'nin ozellikle daha az tecrubeli uzmanlarin, RA bulgularini tespit etmesinde ek katkisini degerlendirmek icin daha buyuk olcekli calismaya ihtiyac bulunmaktadir. Anahtar Kelimeler: Romatoid artrit, tanisal goruntuleme, dijital radyografi