Karademir Ibrahim, Ward Emily, Peng Yahui, Wise Leon, Buckle Christopher, Kunnavakkam Rangesh, Oto Aytekin
Department of Radiology, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Department of Radiology, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Acad Radiol. 2016 Feb;23(2):132-43. doi: 10.1016/j.acra.2015.09.002. Epub 2015 Nov 11.
The purpose of the study was to investigate interobserver and intersequence variability in the measurement of hepatic metastasis on magnetic resonance imaging (MRI).
This retrospective study was conducted with an institutional review board-approved waiver of informed consent and was in compliance with the Health Insurance Portability and Accountability Act. We searched medical records at our institution for patients with histologically proven metastases to the liver who had undergone MRI from January 2008 to June 2010. We identified 20 patients with 30 measurable liver lesions. The liver lesions were measured on five different MRI sequences. A presenter radiologist selected and localized all metastatic lesions considered to be measurable according to the Response Evaluation Criteria in Solid Tumors, and these lesions were measured (Eisenhauer et al., 2009) by three radiologists independently. We calculated lesion-wise intraclass correlation coefficients (ICCs) to estimate interobserver and intersequence agreement in lesion diameter measurement. A Bland-Altman plot was used to estimate the limits of agreement between radiologists and MRI sequences.
There were 30 metastases, and almost all of which had regular and well-defined margins. Interobserver ICCs were greater than 0.95 for different MRI sequences except for the measurements in apparent diffusion coefficient images. Intersequence ICCs were greater than 0.92. Bland-Altman plots between physicians confirmed that reader measurements were closely tied together, with small differences in means.
MRI can reproducibly measure hepatic metastatic lesions without significant variability among interpreting radiologists or among MRI sequences, and is thus a reliable method for assessing the size of hepatic metastasis.
本研究旨在调查磁共振成像（MRI）测量肝转移瘤时观察者间及序列间的变异性。
本回顾性研究在获得机构审查委员会批准的情况下豁免了知情同意，并符合《健康保险流通与责任法案》。我们在本机构的医疗记录中搜索了2008年1月至2010年6月期间接受过MRI检查且组织学证实有肝转移的患者。我们确定了20例患者，其肝脏有30个可测量的病灶。在五种不同的MRI序列上对肝脏病灶进行测量。一名主治放射科医生根据实体瘤疗效评价标准选择并定位所有被认为可测量的转移瘤病灶，然后由三名放射科医生独立测量这些病灶（Eisenhauer等人，2009年）。我们计算了病灶层面的组内相关系数（ICC），以估计观察者间及序列间在病灶直径测量上的一致性。使用Bland-Altman图来估计放射科医生与MRI序列之间的一致性界限。
共有30个转移瘤，几乎所有转移瘤边缘规则且清晰。除表观扩散系数图像测量外，不同MRI序列观察者间的ICC均大于0.95。序列间的ICC大于0.92。医生之间的Bland-Altman图证实，读者测量结果紧密相关，均值差异较小。
MRI能够可重复地测量肝转移瘤病灶，在解读的放射科医生之间或MRI序列之间不存在显著变异性，因此是评估肝转移瘤大小的可靠方法。
