The “Claw Sign” may aid in axial localization in cases of peripherally located canine glioma on MRI

Abstract

AbstractThe “claw sign” is a radiographic sign studied in human imaging to determine if a mass arises from a solid structure or organ versus a close adjacent location, resulting in distortion of the outline of an organ. We investigated its utility in characterizing MRI axial localization of peripherally located intracranial glioma versus meningioma, due to their overlap in MRI appearance. This retrospective, secondary analysis, cross‐sectional study aimed to report the sensitivity, specificity, and inter‐ and intraobserver variabilities using kappa statistics, hypothesizing that the claw sign will have strong inter‐ and intraobserver agreement (κ > 0.8). Dogs with a histologically confirmed diagnosis of peripherally located glioma or meningioma and available 3T MRI data were retrieved from medical record archives from 2009 to 2021. A total of 27 cases, 11 glioma and 16 meningioma, were included. The postcontrast T1‐weighted images were provided to five blinded image evaluators in two separate randomized sessions separated by a 6‐week wash out period. Prior to the first evaluation, evaluators were provided with a training video and set of training cases for the “claw sign,” which were excluded from the study. Evaluators were asked to rate cases as “positive,” “negative,” or “indeterminate” for the “claw sign.” The sensitivity and specificity for the “claw sign” for the first session were 85.5% and 80%, respectively. The interobserver agreement for identifying the “claw sign” was moderate (κ = 0.48), and the intraobserver agreement across the two sessions was substantial (κ = 0.72). These findings indicate the claw sign is supportive but not pathognomonic for intra‐axial localization in cases of canine glioma on MRI.