Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd. Suite 0663, Indianapolis, IN, 46202, USA.
Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA.
Abdom Radiol (NY). 2020 May;45(5):1481-1487. doi: 10.1007/s00261-020-02521-7.
Determine inter-observer variability among radiologists in assigning Cambridge Classification (CC) of chronic pancreatitis (CP) based on magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) and contrast-enhanced CT (CECT).
Among 422 eligible subjects enrolled into the PROCEED study between 6/2017 and 8/2018, 39 were selected randomly for this study (chronic abdominal pain (n = 8; CC of 0), suspected CP (n = 22; CC of 0, 1 or 2) or definite CP (n = 9; CC of 3 or 4). Each imaging was scored by the local radiologist (LRs) and three of five central radiologists (CRs) at other consortium sites. The CRs were blinded to clinical data and site information of the participants. We compared the CC score assigned by the LR with the consensus CC score assigned by the CRs. The weighted kappa statistic (K) was used to estimate the inter-observer agreement.
For the majority of subjects (34/39), the group assignment by LR agreed with the consensus composite CT/MRCP score by the CRs (concordance ranging from 75 to 89% depending on cohort group). There was moderate agreement (63% and 67% agreed, respectively) between CRs and LRs in both the CT score (weighted Kappa [95% CI] = 0.56 [0.34, 0.78]; p-value = 0.57) and the MR score (weighted Kappa [95% CI] = 0.68 [0.49, 0.86]; p-value = 0.72). The composite CT/MR score showed moderate agreement (weighted Kappa [95% CI] = 0.62 [0.43, 0.81]; p-value = 0.80).
There is a high degree of concordance among radiologists for assignment of CC using MRI and CT.
基于磁共振成像（MRI）/磁共振胰胆管成像（MRCP）和对比增强 CT（CECT），确定放射科医生在分配慢性胰腺炎（CP）剑桥分类（CC）时的观察者间变异性。
在 2017 年 6 月至 2018 年 8 月期间纳入 PROCEED 研究的 422 名符合条件的受试者中，随机选择 39 名受试者进行这项研究（慢性腹痛（n=8；CC 为 0）、疑似 CP（n=22；CC 为 0、1 或 2）或明确 CP（n=9；CC 为 3 或 4）。每位影像科医生（LRs）和其他联盟站点的 5 位中心放射科医生（CRs）中的 3 位对每个影像进行评分。CRs 对参与者的临床数据和站点信息不知情。我们比较了 LR 分配的 CC 评分与 CRs 分配的共识 CC 评分。使用加权 Kappa 统计量（K）来估计观察者间的一致性。
对于大多数受试者（34/39），LR 分组与 CRs 的共识综合 CT/MRCP 评分一致（根据队列分组，一致性范围为 75%至 89%）。在 CT 评分（加权 Kappa [95%CI] = 0.56 [0.34, 0.78]；p 值= 0.57）和 MR 评分（加权 Kappa [95%CI] = 0.68 [0.49, 0.86]；p 值= 0.72）方面，CRs 和 LRs 之间存在中度一致（分别有 63%和 67%的结果一致）。综合 CT/MR 评分显示出中度一致性（加权 Kappa [95%CI] = 0.62 [0.43, 0.81]；p 值= 0.80）。
使用 MRI 和 CT 分配 CC 时，放射科医生之间具有高度的一致性。
