Portable Bedside Low-Field MRI for Assessment of Ventricular Size
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: Low-field portable MRI (pMRI) has been shown to be a useful alternative neuroimaging tool in the emergency department (ED) and intensive care unit (ICU), potentially addressing challenges associated with the transport of critically ill patients. We aimed to evaluate the intermodality reliability between low-field pMRI and conventional neuroimaging (CN) for assessment of ventricular size and hydrocephalus. MATERIALS AND METHODS: This retrospective study included all patients who underwent point-of-care 64 mT pMRI at a single tertiary hospital from March 30, 2022 to January 4, 2024, and had a follow-up CN, either CT or MRI, performed within 24 hours of the pMRI scan. Two raters independently evaluated pMRI for presence of hydrocephalus while blinded to CN. Bifrontal diameter, maximum skull, and Evans index were recorded. Interrater and intermodality agreement between pMRI and CN were evaluated by using the intraclass coefficient (ICC) and Cohen κ. RESULTS: Fifty-six patients (mean age of 53.5 [±14.6] years, 61% men) were included in this study. Hydrocephalus was identified in 12 (21%) on pMRI and 13 (23%) on CN. Interrater agreement on pMRI was almost perfect for bifrontal diameter (ICC, 0.94; 95% CI, 0.89–0.97) and Evans index (ICC, 0.92; 95% CI, 0.86–0.95) and substantial for determination of hydrocephalus (κ = 0.72), all P < .01. Intermodality agreement between pMRI and CN was also near perfect for averaged measurements of bifrontal diameter (ICC, 0.94; 95% CI, 0.88–0.97), Evans index (ICC, 0.95; 95% CI, 0.92–0.97), and determination of hydrocephalus (κ = 0.95), all P < .01. Using CN as reference standard, pMRI had sensitivity and specificity of 92% (95% CI, 0.85–0.99) and 100% (95% CI, 1.0–1.0), respectively on qualitative visual assessment, and 80% (95% CI, 0.70–0.90) and 98% (95% CI, 0.94–1.0), respectively, on quantitative assessment by using an Evans index cutoff of 0.3. CONCLUSIONS: Low-field pMRI demonstrated excellent interrater agreement and strong concordance with CN in assessing ventricular size, highlighting its potential as an effective point-of-care tool for neurocritical care applications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".