Department of Radiology, Changhai Hospital of Shanghai, The Naval Military Medical University, No. 168 Changhai Road, Shanghai, 200433, China.
Abdom Radiol (NY). 2020 Mar;45(3):782-788. doi: 10.1007/s00261-019-02125-w.
To compare the tumor size measurements assessed by computed tomography (CT) and magnetic resonance imaging (MRI) versus measurements of resected pathologic specimens from patients with pancreatic ductal adenocarcinoma (PDAC).
This study included 114 patients with histologically confirmed PDAC who underwent contrast-enhanced CT and MRI before surgery. The tumor sizes from CT, MRI, and pathologic specimens were compared by using Bland-Altman analyses and intraclass correlation coefficients (ICCs). The discrepancies in PDAC size between CT/MRI and pathologic specimens were calculated and contributing factors for the discrepancies, including tumor locations (pancreatic head/neck, body, or tail), T stages (T1, T2, or T3), and N stages (N0, N1, or N2), were analyzed with Pearson's correlation coefficients and multivariable linear regression analyses.
There was significant difference among the mean tumor sizes of three measurements (P < 0.001). The difference in mean tumor size between the pathologic sizes for PDAC was 4.3 mm (ICC 0.67) on CT and 5.8 mm (ICC 0.65) on MRI. Both CT and MRI showed wide ranges of limits of agreement (LOAs) between the pathologic specimens for tumor size measurements (LOAs, - 28.9 to 21.4 and - 29.4 to 17.8, respectively). The tumor size on CT or MRI was estimated to be smaller than that on pathology when the tumor was > 30 mm. The discrepancies in the tumor size estimated between CT/MRI and pathologic specimens were significantly different for tumors of different T stages (P < 0.001).
Both contrast-enhanced CT and MRI underestimate the mean tumor size by 4.3 mm and 5.8 mm, respectively, compared to the size of pathologic specimens. A larger tumor size indicates a greater discrepancy in the PDAC size measurements between CT/MRI and pathologic specimens.
比较经计算机断层扫描（CT）和磁共振成像（MRI）评估的肿瘤大小与胰腺导管腺癌（PDAC）患者切除的病理标本测量值。
本研究纳入了 114 例经组织学证实的 PDAC 患者，这些患者在手术前均进行了增强 CT 和 MRI 检查。采用 Bland-Altman 分析和组内相关系数（ICC）比较 CT、MRI 和病理标本的肿瘤大小。计算 CT/MRI 与病理标本之间 PDAC 大小的差异，并采用 Pearson 相关系数和多变量线性回归分析肿瘤位置（胰头/颈、体或尾）、T 分期（T1、T2 或 T3）和 N 分期（N0、N1 或 N2）等因素对差异的影响。
三种测量方法的平均肿瘤大小存在显著差异（P<0.001）。与病理标本相比，CT 上 PDAC 的平均肿瘤大小差异为 4.3mm（ICC 0.67），MRI 上为 5.8mm（ICC 0.65）。CT 和 MRI 均显示病理标本肿瘤大小测量的 LOA 范围较宽（LOA，分别为-28.9 至 21.4 和-29.4 至 17.8）。当肿瘤直径>30mm 时，CT 或 MRI 上的肿瘤大小估计小于病理标本上的肿瘤大小。不同 T 分期的肿瘤，CT/MRI 与病理标本之间肿瘤大小估计的差异有统计学意义（P<0.001）。
与病理标本相比，增强 CT 和 MRI 分别低估了平均肿瘤大小 4.3mm 和 5.8mm。肿瘤越大，CT/MRI 与病理标本之间 PDAC 大小测量的差异越大。
