胃肠胰神经内分泌肿瘤：在重新分期 MRI 上，一致的对比剂选择对放射科医生评估肝病变的信心的影响。

Gastroenteropancreatic neuroendocrine tumors: impact of consistent contrast agent selection on radiologists' confidence in hepatic lesion assessment on restaging MRIs.

机构信息

Department of Radiology, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Boston, MA, USA.

Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, USA.

出版信息

Abdom Radiol (NY). 2018 Jun;43(6):1386-1392. doi: 10.1007/s00261-017-1302-5.

DOI:10.1007/s00261-017-1302-5

PMID:28840281

Abstract

PURPOSE

To evaluate the impact of contrast agent selection on radiologists' confidence in assessing liver lesions on follow-up magnetic resonance imaging (MRI) studies in patients with neuroendocrine tumors.

METHODS

This Institutional Review Board-approved, retrospective study performed at a tertiary cancer center and a quaternary care urban academic hospital included all 694 follow-up abdominal MRI studies from 179 patients with gastroenteropancreatic neuroendocrine tumor performed from 01/01/2010 to 05/31/2015. Primary outcome measure was radiologists' confidence in assessing liver lesions on follow-up MRI. MRI reports were reviewed to abstract radiologists' confidence, classified as "equivocal" if any equivocal connotation (mention of limitation due to differences in contrast agent or follow-up recommendation with specific contrast agent) was present; or "unequivocal" if a precise, confident comparison to prior was documented without the use of ambiguous terms. A fellowship-trained radiologist separately evaluated 100 randomly selected reports and images to calculate interobserver agreement with the report classification (equivocal vs. unequivocal) and with the original MRI report, respectively. Chi-square test was used to compare the proportion of equivocal reports when "same" or "different" contrast agent was used for successive examinations.

RESULTS

Rates of equivocal reports were higher when different contrast agents were used for successive examinations compared to examinations with same contrast agent (13.2% [21/159] vs. 1.8% [10/535]; p < 0.0001). There was very good interobserver agreement for assessment of radiologist confidence (κ = 0.92 for report review, κ = 0.82 for image review).

CONCLUSIONS

Consistent use of contrast agent for follow-up MRIs allows more confident assessment of liver lesions in patients with neuroendocrine tumors.

摘要

目的

评估对比剂选择对评估神经内分泌肿瘤患者随访磁共振成像（MRI）研究中肝脏病变的放射科医生信心的影响。

方法

本研究为回顾性研究，经机构审查委员会批准，在一家三级癌症中心和一家四级城市学术医院进行，纳入了 2010 年 1 月 1 日至 2015 年 5 月 31 日期间 179 例胃肠胰神经内分泌肿瘤患者的 694 例随访腹部 MRI 研究。主要观察指标为放射科医生在随访 MRI 上评估肝脏病变的信心。回顾 MRI 报告以提取放射科医生的信心，如果存在任何模棱两可的含义（提及由于对比剂差异或推荐使用特定对比剂的随访而存在局限性），则将其归类为“不确定”；如果准确、有信心地与之前的结果进行比较，且未使用含糊不清的术语，则归类为“确定”。一名接受过专业培训的放射科医生分别评估了 100 份随机选择的报告和图像，以计算报告分类（不确定与确定）与原始 MRI 报告之间的观察者间一致性。使用卡方检验比较连续检查使用“相同”或“不同”对比剂时不确定报告的比例。