{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:19:25Z","timestamp":1791973165565,"version":"4.3.4"},"reference-count":56,"publisher":"Harborside Press, LLC","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> MRI is assumed to be valid for distinguishing metastatic vertebral fractures (MVFs) from osteoporotic vertebral fractures (OVFs). This study assessed (1) concordance between the image-based diagnosis of MVF versus OVF and the reference (biopsy or follow-up of &gt;6 months), (2) interobserver and intraobserver agreement on key imaging findings and the diagnosis of MVF versus OVF, and (3) whether disclosing a patient\u2019s history of cancer leads to variations in diagnosis, concordance, or agreement. <jats:bold>Patients and Methods:<\/jats:bold> This retrospective cohort study included clinical data and imaging from 203 patients with confirmed MVF or OVF provided to 25 clinicians (neurosurgeons, radiologists, orthopedic surgeons, and radiation oncologists). From January 2018 through October 2018, the clinicians interpreted images in conditions as close as possible to routine practice. Each specialist assessed data twice, with a minimum 6-week interval, blinded to assessments made by other clinicians and to their own previous assessments. The kappa statistic was used to assess interobserver and intraobserver agreement on key imaging findings, diagnosis (MVF vs OVF), and concordance with the reference. Subgroup analyses were based on clinicians\u2019 specialty, years of experience, and complexity of the hospital where they worked. <jats:bold>Results:<\/jats:bold> For diagnosis of MVF versus OVF, interobserver agreement was fair, whereas intraobserver agreement was substantial. Only the latter improved to almost perfect when a patient\u2019s history of cancer was disclosed. Interobserver agreement for key imaging findings was fair or moderate, whereas intraobserver agreement on key imaging findings was moderate or substantial. Concordance between the diagnosis of MVF versus OVF and the reference was moderate. Results were similar regardless of clinicians\u2019 specialty, experience, and hospital category. <jats:bold>Conclusions:<\/jats:bold> When MRI is used to distinguish MVF versus OVF, interobserver agreement and concordance with the reference were moderate. These results cast doubt on the reliability of basing such a diagnosis on MRI in routine practice.<\/jats:p>","DOI":"10.6004\/jnccn.2019.7367","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T20:41:51Z","timestamp":1583440911000},"page":"267-273","source":"Crossref","is-referenced-by-count":9,"title":["Metastatic Versus Osteoporotic Vertebral Fractures on MRI: A Blinded, Multicenter, and Multispecialty Observer Agreement Evaluation"],"prefix":"10.6004","volume":"18","author":[{"given":"Estanislao","family":"Arana","sequence":"first","affiliation":[{"name":"aDepartment of Radiology, Fundaci\u00f3n Instituto Valenciano de Oncolog\u00eda, Valencia;"},{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco M.","family":"Kovacs","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"cUnidad de la Espalda Kovacs, Hospital Universitario HLA-Moncloa, Madrid;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Royuela","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"dClinical Biostatistics Unit, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro-Segovia de Arana, Madrid;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Asenjo","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"eDepartment of Radiology, Hospital Universitario Regional de M\u00e1laga, M\u00e1laga;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Nagib","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"eDepartment of Radiology, Hospital Universitario Regional de M\u00e1laga, M\u00e1laga;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"P\u00e9rez-Aguilera","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"fDepartment of Radiology, Hospital de Manacor, Mallorca;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Dejoz","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"gSchool of Biomedical Engineering, Universitat Polit\u00e8cnica de Valencia, Valencia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Cabrera-Zubizarreta","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"hDepartment of Radiology, Hospital de Galdakao, Galdakao, Bizkaia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Garc\u00eda-Hidalgo","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"iDepartment of Radiology, Hospital Universitario Puerta de Hierro, Madrid; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Estremera","sequence":"additional","affiliation":[{"name":"bSpanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca;"},{"name":"jDepartment of Radiology, Hospital Son Ll\u00e0tzer, Palma de Mallorca, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"ref401","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1001\/jama.2015.1405","article-title":"Diagnostic concordance among pathologists interpreting breast biopsy specimens","volume":"313","author":"Elmore","year":"2015","journal-title":"JAMA"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"E736","DOI":"10.1097\/BRS.0b013e3182458cac","article-title":"Research synthesis: what is the diagnostic performance of magnetic resonance imaging to discriminate benign from malignant vertebral compression fractures? 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