Interrater reliability of a method to assess hypothalamic involvement in pediatric adamantinomatous craniopharyngioma

Restricted access

OBJECTIVE

Pediatric adamantinomatous craniopharyngiomas (ACPs) are histologically benign brain tumors that confer significant neuroendocrine morbidity. Previous studies have demonstrated that injury to the hypothalamus is associated with worsened quality of life and a shorter lifespan. This insight helps many surgeons define the goals of surgery for patients with ACP. Puget and colleagues proposed a 3-tiered preoperative and postoperative grading system based on the degree of hypothalamic involvement identified on MRI. In a prospective cohort from their institution, the authors found that use of the system to guide operative goals was associated with decreased morbidity. To date, however, the Puget system has not been externally validated. Here, the authors present an interrater reliability study that assesses the generalizability of this system for surgeons planning initial operative intervention for children with craniopharyngiomas.

METHODS

A panel of 6 experts, consisting of pediatric neurosurgeons and pediatric neuroradiologists, graded 30 preoperative and postoperative MRI scans according to the Puget system. Interrater reliability was calculated using Fleiss’ κ and Krippendorff’s α statistics.

RESULTS

Interrater reliability in the preoperative context demonstrated moderate agreement (κ = 0.50, α = 0.51). Interrater reliability in the postoperative context was 0.27 for both methods of statistical evaluation.

CONCLUSIONS

Interrater reliability for the system as defined is moderate. Slight refinements of the Puget MRI grading system, such as collapsing the 3 grades into 2, may improve its reliability, making the system more generalizable.

ABBREVIATIONS ACP = adamantinomatous craniopharyngioma; GTR = gross-total resection; STR = subtotal resection.
Article Information

Contributor Notes

Correspondence Ros Whelan: University of Colorado, Aurora, CO. ros.whelan@ucdenver.edu.INCLUDE WHEN CITING Published online October 11, 2019; DOI: 10.3171/2019.8.PEDS19295.Disclosures Dr. Bahtia: consultant for Guerbet.
Headings
References
  • 1

    Chang KBai HXZhou HSu CBi WLAgbodza E: Residual convolutional neural network for determination of IDH status in low- and high-grade gliomas from MR imaging. Clin Cancer Res 24:107310812018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Clark AJCage TAAranda DParsa ATAuguste KIGupta N: Treatment-related morbidity and the management of pediatric craniopharyngioma: a systematic review. J Neurosurg Pediatr 10:2933012012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Daubenbüchel AMMüller HL: Neuroendocrine disorders in pediatric craniopharyngioma patients. J Clin Med 4:3894132015

  • 4

    Dumont TMRughani AITranmer BI: Prediction of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network: feasibility and comparison with logistic regression models. World Neurosurg 75:57–6325282011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5

    Elliott REJane JA JrWisoff JH: Surgical management of craniopharyngiomas in children: meta-analysis and comparison of transcranial and transsphenoidal approaches. Neurosurgery 69:6306432011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Elliott REWisoff JH: Surgical management of giant pediatric craniopharyngiomas. J Neurosurg Pediatr 6:4034162010

  • 7

    Fjalldal SHolmer HRylander LElfving MEkman BOsterberg K: Hypothalamic involvement predicts cognitive performance and psychosocial health in long-term survivors of childhood craniopharyngioma. J Clin Endocrinol Metab 98:325332622013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Fleiss JL: Measuring nominal scale agreement among many raters. Psychol Bull 76:3783821971

  • 9

    Hankinson TCFields ECTorok MRBeaty BLHandler MHForeman NK: Limited utility despite accuracy of the national SEER dataset for the study of craniopharyngioma. J Neurooncol 110:2712782012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10

    Hayes AFKrippendorff K: Answering the call for a standard reliability measure for coding data. Commun Methods Meas 1:77892007

  • 11

    Heinks KBoekhoff SHoffmann AWarmuth-Metz MEveslage MPeng J: Quality of life and growth after childhood craniopharyngioma: results of the multinational trial KRANIOPHARYNGEOM 2007. Endocrine 59:3643722018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Kiehna ENMerchant TE: Radiation therapy for pediatric craniopharyngioma. Neurosurg Focus 28(4):E102010

  • 13

    Krippendorff K: Estimating the reliability, systematic error and random error of interval data. Educ Psychol Meas 30:61701970

  • 14

    Landis JRKoch GG: The measurement of observer agreement for categorical data. Biometrics 33:1591741977

  • 15

    Mallucci CPizer BBlair JDidi MDoss AUpadrasta S: Management of craniopharyngioma: the Liverpool experience following the introduction of the CCLG guidelines. Introducing a new risk assessment grading system. Childs Nerv Syst 28:118111922012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Müller H: Craniopharyngioma—a chronic disease. Swiss Med Wkly 148:w145482018

  • 17

    Müller HL: Childhood craniopharyngioma—current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol 6:6096182010

  • 18

    Müller HLGebhardt UTeske CFaldum AZwiener IWarmuth-Metz M: Post-operative hypothalamic lesions and obesity in childhood craniopharyngioma: results of the multinational prospective trial KRANIOPHARYNGEOM 2000 after 3-year follow-up. Eur J Endocrinol 165:17242011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Müller HLMerchant TEPuget SMartinez-Barbera JP: New outlook on the diagnosis, treatment and follow-up of childhood-onset craniopharyngioma. Nat Rev Endocrinol 13:2993122017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Ostrom QTGittleman HXu JKromer CWolinsky YKruchko C: CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2009-2013. Neuro Oncol 18 (suppl_5):v1v752016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21

    Pascual JMGonzález-Llanos FBarrios LRoda JM: Intraventricular craniopharyngiomas: topographical classification and surgical approach selection based on an extensive overview. Acta Neurochir (Wien) 146:7858022004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Pascual JMPrieto RCarrasco R: Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category. Acta Neurochir (Wien) 153:240324262011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23

    Prieto RPascual JMBarrios L: Topographic diagnosis of craniopharyngiomas: The accuracy of MRI findings observed on conventional T1 and T2 images. AJNR Am J Neuroradiol 38:207320802017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Prieto RPascual JMCastro-Dufourny ICarrasco RBarrios L: Craniopharyngioma: surgical outcome as related to the degree of hypothalamic involvement. World Neurosurg 104:100610102017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Prieto RPascual JMRosdolsky MCastro-Dufourny ICarrasco RStrauss S: Craniopharyngioma adherence: a comprehensive topographical categorization and outcome-related risk stratification model based on the methodical examination of 500 tumors. Neurosurg Focus 41(6):E132016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Proutskova PGruszczynski M: kripp.boot – An R package for performing bootstrap replicates of Krippendorff’s alpha on intercoder reliability data. GitHub, Inc. (https://github.com/MikeGruz/kripp.boot) [Accessed August 23 2019]

    • Export Citation
  • 27

    Puget SGarnett MWray AGrill JHabrand JLBodaert N: Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 106 (1 Suppl):3122007

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Rughani AIDumont TMLu ZBongard JHorgan MAPenar PL: Use of an artificial neural network to predict head injury outcome. J Neurosurg 113:5855902010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Sainte-Rose CPuget SWray AZerah MGrill JBrauner R: Craniopharyngioma: the pendulum of surgical management. Childs Nerv Syst 21:6916952005

  • 30

    Sterkenburg ASHoffmann AGebhardt UWarmuth-Metz MDaubenbüchel AMMüller HL: Survival, hypothalamic obesity, and neuropsychological/psychosocial status after childhood-onset craniopharyngioma: newly reported long-term outcomes. Neuro Oncol 17:102910382015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Van Gompel JJNippoldt TBHiggins DMMeyer FB: Magnetic resonance imaging-graded hypothalamic compression in surgically treated adult craniopharyngiomas determining postoperative obesity. Neurosurg Focus 28(4):E32010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32

    Yano SHide TShinojima N: Surgical outcomes of endoscopic endonasal skull base surgery of craniopharyngiomas evaluated according to the degree of hypothalamic extension. World Neurosurg 100:2882962017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Yano SKudo MHide TShinojima NMakino KNakamura H: Quality of life and clinical features of long-term survivors surgically treated for pediatric craniopharyngioma. World Neurosurg 85:1531622016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Zacharia BEBruce SSGoldstein HMalone HRNeugut AIBruce JN: Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro Oncol 14:107010782012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Zada GLaws ER: Surgical management of craniopharyngiomas in the pediatric population. Horm Res Paediatr 74:62662010

  • 36

    Zapf ACastell SMorawietz LKarch A: Measuring inter-rater reliability for nominal data—which coefficients and confidence intervals are appropriate? BMC Med Res Methodol 16:932016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
TrendMD
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 171 171 78
Full Text Views 27 27 14
PDF Downloads 16 16 9
EPUB Downloads 0 0 0
PubMed
Google Scholar