Department of radiology, Reims university hospital, 51092 Reims, France.
Department of research and innovation, Reims university hospital, 51100 Reims, France.
Diagn Interv Imaging. 2018 Feb;99(2):73-81. doi: 10.1016/j.diii.2017.12.009. Epub 2018 Jan 12.
To assess dimension measurement variability of liver metastases from neuroendocrine tumors (LMNET) on different magnetic resonance imaging (MRI) sequences.
In this institutional review board-approved retrospective study from January 2011 to December 2012, all liver MRI examinations performed at our department in patients with at least one measurable LMNET according to response evaluation criteria in solid tumors (RECIST1.1) were included. Up to two lesions were selected on T2-weighted MR images. Three reviewers independently measured long axes of 135 hepatic metastases in 30 patients (16 men, 14 women, mean age 61±11.4 (SD) years; range 28-78 years), during two separate reading sessions, on T2-weighted, diffusion-weighted MRI (DWI) (b; 50, 400, 800 s/mm) and arterial, portal and late phases after intravenous administration of a gadolinium chelate. Intraclass-correlation coefficients and Bland-Altman plots were used to assess intra-and interobserver variability.
Intra- and interobserver agreements ranged between 0.87-0.98, and 0.88-0.97, respectively. Intersequence agreements ranged between 0.92 [95%CI: 0.82-0.98] and 0.98 [95%CI: 0.93-0.99]. 95% limits of agreement for measurements were -10.2%,+8.9% for DWI (b=50s/mm) versus -21.9%,+24.2% and -15.8,+17.2% for arterial and portal phases, respectively.
An increase<9% in measurement and a decrease of -10% on DWI should not be considered as true changes, with 95% confidence, versus 24% and -22% on arterial and 17%, -16% on portal phases, respectively. DWI might thus be the most reliable MR sequence for monitoring size variations of LMNETs.
评估神经内分泌肿瘤肝转移瘤（LMNET）在不同磁共振成像（MRI）序列中的尺寸测量变异性。
在这项机构审查委员会批准的回顾性研究中，我们从 2011 年 1 月至 2012 年 12 月在我们科室进行了所有的肝脏 MRI 检查，这些患者至少有一个可测量的 LMNET，根据实体瘤反应评估标准（RECIST1.1）。在 T2 加权 MR 图像上最多选择两个病变。三名观察者分别在两次独立的阅读会议期间，在 30 名患者（16 名男性，14 名女性，平均年龄 61±11.4（SD）岁；年龄范围 28-78 岁）的 135 个肝脏转移瘤的长轴上进行测量，在静脉注射钆螯合物后进行动脉期、门静脉期和晚期 T2 加权、弥散加权 MRI（DWI）（b；50、400、800 s/mm）。使用组内相关系数和 Bland-Altman 图评估观察者内和观察者间的变异性。
观察者内和观察者间的一致性分别在 0.87-0.98 和 0.88-0.97 之间。序列间的一致性分别在 0.92[95%CI：0.82-0.98]和 0.98[95%CI：0.93-0.99]之间。DWI（b=50s/mm）与动脉期和门静脉期相比，测量值的 95%置信区间为-10.2%，+8.9%和-21.9%，+24.2%和-15.8%，+17.2%。因此，DWI 可能是监测 LMNET 大小变化最可靠的 MRI 序列。
