The Institute of Cancer Research, London, UK.
The Royal Marsden Hospital, London, UK.
Cancer Imaging. 2020 Jul 14;20(1):48. doi: 10.1186/s40644-020-00328-9.
Whole body magnetic resonance imaging (MRI) is now incorporated into international guidance for imaging patients with multiple myeloma. The aim of this study was to investigate inter-observer agreement of triple reported baseline whole-body MRI in myeloma and highlight potential pitfalls.
Fifty-seven patients with symptomatic myeloma at first presentation or relapse and planned for autologous stem cell transplant were included. All patients completed baseline whole body MRI within 2 weeks prior to starting treatment. Each scan was reported independently by 3 radiologists using a defined scoring system. Differences in observer scores were compared using analysis of variance (ANOVA) and inter-observer agreement assessed using intra class correlation coefficient (ICC).
There was no significant difference in mean observer scores for whole skeleton and ICC demonstrated excellent inter-observer agreement at 0.91. ICC varied between skeletal regions with spine, pelvis and ribs showing good inter-observer agreement, whereas skull and long bones were moderate. Scans with variation in observer scores were re-examined and cause of discrepancies identified. This information was used to describe potential anatomical pitfalls in reporting .
Whole-body MRI has excellent inter-observer agreement in reporting symptomatic myeloma at baseline. Inter-observer agreement varied between skeletal regions highlighting specific areas of difficulty.
全身磁共振成像（MRI）现已纳入多发性骨髓瘤患者影像学检查的国际指南。本研究旨在探讨多发性骨髓瘤患者基线全身 MRI 三重报告的观察者间一致性，并强调潜在的误区。
57 例初诊或复发的有症状多发性骨髓瘤患者计划接受自体干细胞移植。所有患者均在治疗前 2 周内完成基线全身 MRI 检查。每个扫描均由 3 名放射科医生独立使用定义的评分系统进行报告。使用方差分析（ANOVA）比较观察者评分的差异，并使用组内相关系数（ICC）评估观察者间的一致性。
整体骨骼的平均观察者评分无显著差异，ICC 显示观察者间具有极好的一致性，为 0.91。ICC 在骨骼区域之间存在差异，脊柱、骨盆和肋骨具有良好的观察者间一致性，而颅骨和长骨则为中度。对观察者评分存在差异的扫描进行重新检查，并确定差异的原因。这些信息用于描述报告中的潜在解剖误区。
在报告有症状多发性骨髓瘤的基线全身 MRI 中，观察者间具有极好的一致性。观察者间的一致性在骨骼区域之间存在差异，突出了特定的困难区域。
