Center for Evidence-Based Imaging and Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Radiology. 2011 Apr;259(1):136-41. doi: 10.1148/radiol.10100970. Epub 2011 Feb 3.
To estimate the prevalence of focal cystic pancreatic lesions (FCPLs) among patients undergoing computed tomographic (CT) or magnetic resonance (MR) imaging at one institution and to examine any variation in radiologists' recommendation practice pattern with regards to FCPLs.
Institutional review board approval was obtained for this retrospective HIPPA-compliant study. The requirement to obtain informed consent was waived. A cohort of patients with FCPLs was identified from radiology reports by using natural language processing. Patient-specific (ie, age, sex, symptoms, history of pancreatitis), radiologist-specific (ie, years of experience, area of expertise), and FCPL-specific (ie, size, location, septation, calcification, mural nodularity, pancreatic duct involvement, and presence of multiple cysts) variables were obtained. The outcome measure was whether a follow-up study was recommended. A logistic regression model was used to identify relative recommendation rates after controlling for key explanatory variables.
Between January 1 and December 31, 2009, a total of 1067 FCPLs were identified in 765 patients. Prevalence rates ranged from 2.2% at CT to 15.9% at MR imaging. Radiologists recommended a follow-up imaging study in 23.7% of cases of a FCPL. A 2.8-fold difference in the rate of recommendation of further imaging existed across radiologists after controlling for explanatory variables such as lesion-, radiologist-, and patient-specific characteristics. A history of pancreatitis was associated with a nearly two-fold decrease in recommending further imaging.
FCPLs are common, and nearly one-quarter of radiology reports recommend at least one follow-up imaging study. Significant variation exists in the rate of recommendation for further imaging studies by radiologists, even after controlling for key explanatory variables.
估计在一家机构行 CT 或 MR 成像检查的患者中局灶性囊性胰腺病变（FCPL）的患病率，并检查放射科医生对 FCPL 的推荐实践模式是否存在任何变化。
本回顾性 HIPAA 符合研究获得了机构审查委员会的批准。豁免了获得知情同意的要求。通过自然语言处理从放射学报告中确定 FCPL 患者的队列。获取了患者特异性（即年龄、性别、症状、胰腺炎病史）、放射科医生特异性（即经验年限、专业领域）和 FCPL 特异性（即大小、位置、分隔、钙化、壁结节、胰管受累和多个囊肿存在）变量。结局指标是是否推荐进行随访研究。使用逻辑回归模型在控制关键解释变量后确定相对推荐率。
2009 年 1 月 1 日至 12 月 31 日，在 765 名患者中共发现 1067 个 FCPL。患病率范围从 CT 的 2.2%到 MR 成像的 15.9%。在 FCPL 病例中，放射科医生建议进行 23.7%的随访影像学研究。在控制病变、放射科医生和患者特征等解释变量后，放射科医生推荐进一步影像学检查的比率存在 2.8 倍的差异。胰腺炎病史与推荐进一步影像学检查的可能性降低近两倍相关。
FCPL 很常见，近四分之一的放射学报告建议至少进行一次随访影像学研究。即使在控制关键解释变量后，放射科医生对进一步影像学研究的推荐率也存在显著差异。
