不同经验水平的放射科医生之间PI-RADS v. 2词典的观察者间一致性。
Interobserver agreement of PI-RADS v. 2 lexicon among radiologists with different levels of experience.
作者信息
Mussi Thais C, Yamauchi Fernando I, Tridente Cássia F, Tachibana Adriano, Tonso Victor M, Recchimuzzi Débora Z, Leão Layra R S, Luz Daniel C, Martins Tatiana, Baroni Ronaldo H
机构信息
Radiology and Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Radiology and Diagnostic Imaging Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.
出版信息
J Magn Reson Imaging. 2020 Feb;51(2):593-602. doi: 10.1002/jmri.26882. Epub 2019 Aug 1.
BACKGROUND
Evaluation of interobserver agreement of the PI-RADS v2 lexicon is important to validate the uniformity of this widely used classification.
PURPOSE
To determine the interobserver agreement of PI-RADS v2 lexicon among eight radiologists with varying levels of experience.
STUDY TYPE
Retrospective.
POPULATION
In all, 160 consecutively imaged men with confirmatory targeted biopsy.
FIELD STRENGTH/SEQUENCE: 3T scanner without an endorectal coil. T -weighted imaging (T w), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) map and dynamic contrast-enhanced sequence were performed.
ASSESSMENT
Eight radiologists (two highly experienced, two moderately experienced, and four less experienced) independently read 130 lesions in the peripheral zone (PZ) and 30 lesions in the transition zone (TZ), blinded to clinical MRI indication and biopsy results. The features described in PI-RADS v2 for TZ and PZ lesions were evaluated.
STATISTICAL TESTS
Conger's kappa, percentage of concordance, and first-order agreement coefficient (AC1) were used to evaluate interobserver agreement.
RESULTS
From the features evaluated on PZ lesions, definite extraprostatic extension (EPE) / invasive behavior on T w had good agreement (AC1 = 0.80), and the others had fair agreement (AC1 = 0.32-0.40). From the features evaluated on TZ lesions, two had good agreement: definite EPE/invasive behavior (AC1 = 0.77) and moderate/marked hypointensity (AC1 = 0.67) on T w. Encapsulation and lenticular shape on T w, focal (not indistinct) on DWI and ADC map, and marked hypointensity on ADC map (AC1 = 0.45 to 0.60) had moderate agreement, whereas heterogeneous and circumscribed (not obscured margins) on T w, marked hyperintensity on high-b-value DWI, and the presence or not of early enhancement in the lesion/region of the lesion (AC1 = 0.30 to 0.38) had fair agreement.
DATA CONCLUSION
Interobserver agreement in PI-RADS v2 lexicon ranges from fair to good among radiologists and improves with increasing experience.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:593-602.
背景
评估PI-RADS v2词典的观察者间一致性对于验证这种广泛使用的分类方法的一致性很重要。
目的
确定八名经验水平不同的放射科医生之间PI-RADS v2词典的观察者间一致性。
研究类型
回顾性研究。
研究对象
总共160名经确认进行了靶向活检的连续成像男性。
场强/序列：3T扫描仪，无直肠内线圈。进行了T加权成像（T w）、扩散加权成像（DWI）、表观扩散系数（ADC）图和动态对比增强序列检查。
评估
八名放射科医生（两名经验丰富、两名经验中等、四名经验较少）在不知道临床MRI指征和活检结果的情况下，独立阅读了外周带（PZ）的130个病变和移行带（TZ）的30个病变。评估了PI-RADS v2中描述的TZ和PZ病变的特征。
统计检验
使用康格kappa系数、一致性百分比和一阶一致性系数（AC1）来评估观察者间一致性。
结果
从对PZ病变评估的特征来看，T w上明确的前列腺外延伸（EPE）/浸润行为一致性良好（AC1 = 0.80），其他特征一致性一般（AC1 = 0.32 - 0.40）。从对TZ病变评估的特征来看，有两个特征一致性良好：T w上明确的EPE/浸润行为（AC1 = 0.77）和中等/明显低信号（AC1 = 0.67）。T w上的包膜和透镜状形态、DWI和ADC图上的局灶性（非模糊）、ADC图上的明显低信号（AC1 = 0.45至0.60）一致性中等，而T w上的不均匀性和边界清晰（非模糊边界）、高b值DWI上的明显高信号以及病变/病变区域是否存在早期强化（AC1 = 0.30至0.38）一致性一般。
数据结论
放射科医生之间PI-RADS v2词典的观察者间一致性从一般到良好不等，且随着经验增加而提高。
证据水平
2 技术效能：2级 J.Magn.Reson.Imaging 2020;51:593 - 602。
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