Hellström J, Romanos Zapata R, Libard S, Wikström J, Ortiz-Nieto F, Alafuzoff I, Raininko R
Department of Radiology, Uppsala University, Uppsala, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Neuroradiology. 2019 Jan;61(1):43-53. doi: 10.1007/s00234-018-2129-7. Epub 2018 Nov 15.
We evaluated in a clinical setting the INTERPRET decision-support system (DSS), a software generated to aid in MRS analysis to achieve a specific diagnosis for brain lesions.
The material consisted of 100 examinations of focal intracranial lesions with confirmed diagnoses. MRS was obtained at 1.5 T using TE 20-30 ms. Data were processed with the LCModel for conventional analysis. The INTERPRET DSS 3.1. was used to obtain specific diagnoses. MRI and MRS were reviewed by one interpreter. DSS analysis was made by another interpreter, in 80 cases by two interpreters. The diagnoses were compared with the definitive diagnoses. For comparisons between DSS, conventional MRS analysis, and MRI, the diagnoses were categorised: high-grade tumour, low-grade tumour, non-neoplastic lesion.
Interobserver agreement in choosing the diagnosis from the INTERPRET database was 75%. The diagnosis was correct in 38/100 cases, incorrect in 57 cases. No good match was found in 5/100 cases. The diagnostic category was correct with DSS/conventional MRS/MRI in 67/58/52 cases, indeterminate in 5/8/20 cases, incorrect in 28/34/28 cases. Results with DSS were not significantly better than with conventional MRS analysis. All definitive diagnoses did not exist in the INTERPRET database. In the 61 adult patients with the diagnosis included in the database, DSS/conventional MRS/MRI yielded a correct diagnosis category in 48/32/29 cases (DSS vs conventional MRS: p = 0.002, DSS vs MRI: p = 0.0004).
Use of the INTERPRET DSS did not improve MRS categorisation of the lesions in the unselected clinical cases. In adult patients with lesions existing in the INTERPRET database, DSS improved the results, which indicates the potential of this software with an extended database.
我们在临床环境中评估了INTERPRET决策支持系统（DSS），这是一款为辅助磁共振波谱（MRS）分析以实现对脑病变的特定诊断而生成的软件。
材料包括100例已确诊的局灶性颅内病变检查。在1.5T场强下，采用20 - 30ms的回波时间（TE）获取MRS。数据用LCModel进行常规分析。使用INTERPRET DSS 3.1获取特定诊断。由一名解读员审查MRI和MRS。DSS分析由另一名解读员进行，80例由两名解读员进行。将诊断结果与最终诊断进行比较。为了比较DSS、常规MRS分析和MRI，将诊断分类为：高级别肿瘤、低级别肿瘤、非肿瘤性病变。
从INTERPRET数据库中选择诊断时，观察者间一致性为75%。100例中诊断正确的有38例，错误的有57例。100例中有5例未找到良好匹配。DSS/常规MRS/MRI诊断类别正确的分别为67/58/52例，不确定的分别为5/8/20例，错误的分别为28/34/28例。DSS的结果并不比常规MRS分析显著更好。INTERPRET数据库中不存在所有的最终诊断。在数据库中包含诊断结果的61例成年患者中，DSS/常规MRS/MRI在48/32/29例中得出了正确的诊断类别（DSS与常规MRS比较：p = 0.002，DSS与MRI比较：p = 0.0004）。
在未选择的临床病例中，使用INTERPRET DSS并未改善病变的MRS分类。在INTERPRET数据库中存在病变的成年患者中，DSS改善了结果，这表明该软件在扩展数据库时有潜力。
