Tsurusaki Masakatsu, Numoto Isao, Oda Teruyoshi, Wakana Miyuki, Suzuki Ayako, Yagyu Yukinobu, Matsuki Mitsuru, Ishii Kazunari
Department of Radiology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Cancers (Basel). 2020 Jun 3;12(6):1455. doi: 10.3390/cancers12061455.
The aim of this study was to investigate the impact of radiologic experience on the diagnostic accuracy of computed tomography (CT) vs. magnetic resonance imaging (MRI) reporting on the liver metastases of pancreatic ductal adenocarcinoma (LM of PDAC). Intra-individual CT and MRI examinations of 112 patients with clinically proven LM of PDAC were included. Four radiologists with varying years of experience (A > 20, B > 5, C > 1 and D < 1) assessed liver segments affected by LM of PDAC, as well as associated metastases occurring in each patient. Their sensitivity and specificity in evaluating the segments were compared. Cohen's Kappa (κ) for diagnosed liver segments and Intra-class Correlation Coefficients (ICC) for the number of metastatic lesions in each patient were calculated. The radiologists' sensitivity and specificity for the CT vs. MRI were, respectively: Reader A-94.4%, 90.3% vs. 96.6%, 94.8%; B-86.7%, 79.7% vs. 83.9%, 82.0%; C-78.0%, 76.7% vs. 83.3%, 78.9% and D-71.8%, 79.2% vs. 64.0%, 69.5%. Reviewers A and B achieved greater agreement in assessing results from the MRI (κ = 0.72, < 0.001; ICC = 0.73, < 0.001) vs. the CT (κ = 0.58, < 0.001; ICC = 0.61, < 0.001), in contrast to readers C and D (MRI: κ = 0.34, < 0.001; ICC = 0.42, < 0.001, and CT: κ = 0.48, < 0.001; ICC = 0.59, < 0.001). Our results indicate that the accurate diagnosis of LM of PDAC depends more on radiologic experience in MRI over CT scans.
本研究的目的是调查放射学经验对计算机断层扫描（CT）与磁共振成像（MRI）报告胰腺导管腺癌肝转移（PDAC的LM）诊断准确性的影响。纳入了112例临床确诊为PDAC的LM患者的个体内CT和MRI检查。四名具有不同经验年限的放射科医生（A>20年、B>5年、C>1年和D<1年）评估了受PDAC的LM影响的肝段，以及每位患者发生的相关转移灶。比较了他们在评估这些肝段时的敏感性和特异性。计算了诊断肝段的科恩kappa（κ）值和每位患者转移灶数量的组内相关系数（ICC）。放射科医生对CT与MRI的敏感性和特异性分别为：A医生-94.4%、90.3%对96.6%、94.8%；B医生-86.7%、79.7%对83.9%、82.0%；C医生-78.0%、76.7%对83.3%、78.9%；D医生-71.8%、79.2%对64.0%、69.5%。与C医生和D医生相比，A医生和B医生在评估MRI结果（κ=0.72，P<0.001；ICC=0.73，P<0.001）方面比评估CT结果（κ=0.58，P<0.001；ICC=0.61，P<0.001）达成了更高的一致性（MRI：κ=0.34，P<0.001；ICC=0.42，P<0.001，CT：κ=0.48，P<0.001；ICC=0.59，P<0.001）。我们的结果表明，PDAC的LM的准确诊断更多地取决于MRI而非CT扫描方面的放射学经验。
