Validation of a shortened MR imaging protocol for pediatric spinal pathology
Bibliographic record
Abstract
Abstract Objective Conventional pediatric spine MRI protocols have multiple sequences resulting in long acquisition times. Sedation is consequently required. This study evaluates the diagnostic capability of a limited MRI spine protocol for selected common pediatric indications. Methods Spine MRIs at CHEO between 2017 and 2020 were reviewed across pediatric patients younger than four years old. Two blinded neuroradiologists reviewed limited scan sequences and results were independently compared to previously reported findings from the complete imaging series. T2 sagittal sequences from the craniocervical junction to sacrum and T1 axial sequence of the lumbar spine constitute the short protocol, with the outcomes of interest being cerebellar ectopia, syrinx, level of conus, filum < 2mm, fatty filum, and spinal dysraphism. Results 105 studies were evaluated in 54 male and 51 female patients (mean age 19.2 months). The average combined scan time of the limited sequences was 15 minutes compared to 35 minutes for conventional protocols (delta = 20 minutes). The average percent agreement between full and limited sequences was > 95% in all but identifying a filum < 2mm, where the percent agreement was 87%. Using limited MR sequences had high sensitivity (> 0.91) and specificity (> 0.99) for the detection of cerebellar ectopia, syrinx, fatty filum, and spinal dysraphism. Conclusion This study demonstrates that selected spinal imaging sequences allow for consistent and accurate diagnosis of specific clinical conditions. A limited spine imaging protocol has potential as a screening test to reduce the need for full sequence MRI scans. Further work is needed to determine utility of selected imaging for other clinical indications.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".