Reproducibility of qualitative assessments of temporal lobe atrophy in MRI studies

Abstract

Objective: To determine the reproducibility of the Scheltens visual rating scale in establishing atrophy of the medial temporal lobe.

Material and methods: We used coronal T1-weighted inversion recovery sequences on a 1.5 Tesla MRI scanner to study 25 patients with clinically diagnosed Alzheimer's disease or mild cognitive decline and 25 subjects without cognitive decline. Five neuroradiologists trained to apply the Scheltens visual rating scale analyzed the images. We used the interclass correlation coefficient to evaluate interrater and intrarater agreement.

Results: Raters scored 20 (80%) of the 25 patients with mild cognitive decline or Alzheimer's disease between 2 and 4; by contrast, they scored 21 (84%) of the 25 subjects without cognitive decline between 0 and 1. The interrater agreement was consistently greater than 0.82, with a 95% confidence interval of (0.7-0.9). The intrarater agreement ranged from 0.82 to 0.87, with a 95% confidence interval of (0.56-0.93).

Conclusion: The Scheltens visual rating scale is reproducible among observers, and this finding supports its use in clinical practice.

Keywords: Alzheimer's disease; Atrofia cerebral; Brain atrophy; Demencia; Dementia; Deterioro cognitivo leve; Enfermedad de Alzheimer; Lóbulo temporal; Mild cognitive decline; Temporal lobe.