Department of Radiology, Aalborg University Hospital, P.O. Box 365, 9100, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abdom Radiol (NY). 2020 May;45(5):1468-1480. doi: 10.1007/s00261-020-02466-x.
There is an unmet need for new systems with quantitative pancreatic imaging assessments to support better diagnosis and understand development of chronic pancreatitis (CP). The aims were to present such an approach for assessment of imaging features in CP, to apply this system in a multi-center cohort of CP patients (feasibility study), and to report inter-reader agreement between expert radiologists (validation study).
The feasibility study included pancreatic computed tomography (CT) or magnetic resonance imaging (MRI) from 496 patients with definitive CP in the Scandinavian Baltic Pancreatic Club (SBPC) database. Images were assessed according to the new SBPC imaging system (quantitative assessments of ductal and parenchymal features). Inter-reader agreement of reported imaging parameters was investigated for 80 CT and 80 MRI examinations by two expert radiologists.
Reporting of the imaging features into the imaging system was deemed feasible for > 80% of CT and > 90% of MRI examinations. Quantitative assessments of main pancreatic duct diameters, presence/number/diameter of calcifications, and gland diameters had high levels of inter-reader agreement with κ-values of 0.75-0.87 and intraclass correlation coefficients of 0.74-0.97. The more subjective assessments, e.g., irregular main pancreatic duct and dilated side-ducts, had poor to moderate agreement with κ-values of 0.03-0.44.
The presented system provides a feasible mean for systematic assessment of CP imaging features. Imaging parameters based on quantitative assessment, as opposed to subjective assessments, have better reproducibility and should be preferred in the development of new grading systems for understanding pathophysiology and disease progression in CP.
需要新的系统进行定量胰腺成像评估，以支持更好的诊断和了解慢性胰腺炎（CP）的发展。目的是提出一种用于评估 CP 成像特征的方法，将该系统应用于 CP 多中心队列患者（可行性研究），并报告专家放射科医生之间的读者间协议（验证研究）。
可行性研究纳入了斯堪的纳维亚波罗的海胰腺俱乐部（SBPC）数据库中 496 例明确 CP 患者的胰腺计算机断层扫描（CT）或磁共振成像（MRI）。根据新的 SBPC 成像系统（对导管和实质特征的定量评估）评估图像。通过两位专家放射科医生对 80 例 CT 和 80 例 MRI 检查的报告成像参数进行读者间协议研究。
将成像特征报告到成像系统对于>80%的 CT 和>90%的 MRI 检查是可行的。主胰管直径、钙化的存在/数量/直径以及腺体直径的定量评估具有较高的读者间一致性，κ 值为 0.75-0.87，组内相关系数为 0.74-0.97。更主观的评估，例如不规则的主胰管和扩张的侧支胰管，具有较差到中等的一致性，κ 值为 0.03-0.44。
所提出的系统为系统评估 CP 成像特征提供了可行的手段。基于定量评估的成像参数与主观评估相比，具有更好的可重复性，应优先用于开发新的分级系统，以了解 CP 中的病理生理学和疾病进展。
