Shinagare Atul B, Davenport Matthew S, Park Hyesun, Pedrosa Ivan, Remer Erick M, Chandarana Hersh, Doshi Ankur M, Schieda Nicola, Smith Andrew D, Vikram Raghunandan, Wang Zhen J, Silverman Stuart G
Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA.
Dana-Farber Cancer Institute, Boston, USA.
Abdom Radiol (NY). 2021 Feb;46(2):703-722. doi: 10.1007/s00261-020-02644-x. Epub 2020 Aug 18.
There is substantial variation in the radiologic terms used to characterize renal masses, leading to ambiguity and inconsistency in clinical radiology reports and research studies. The purpose of this study was to develop a standardized lexicon to describe renal masses at CT and MRI.
This multi-institutional, prospective, quality improvement project was exempt from IRB oversight. Thirteen radiologists belonging to the Society of Abdominal Radiology (SAR) disease-focused panel on renal cell carcinoma representing nine academic institutions participated in a modified Delphi process to create a lexicon of terms used to describe imaging features of renal masses at CT and MRI. In the first round, members voted on terms to be included and proposed definitions; subsequent voting rounds and a teleconference established consensus. One non-voting member developed the questionnaire and consolidated responses. Consensus was defined as ≥ 80% agreement.
Of 37 proposed terms, 6 had consensus to be excluded. Consensus for inclusion was reached for 30 of 31 terms (13/14 basic imaging terms, 8/8 CT terms, 6/6 MRI terms and 3/3 miscellaneous terms). Despite substantial initial disagreement about definitions of 'renal mass,' 'necrosis,' 'fat,' and 'restricted diffusion' in the first round, consensus for all was eventually reached. Disagreement remained for the definition of 'solid mass.'
A modified Delphi method produced a lexicon of preferred terms and definitions to be used in the description of renal masses at CT and MRI. This lexicon should improve clarity and consistency of radiology reports and research related to renal masses.
用于描述肾肿块的放射学术语存在很大差异，导致临床放射学报告和研究中的模糊性和不一致性。本研究的目的是开发一种标准化词汇表，用于在CT和MRI上描述肾肿块。
这项多机构、前瞻性、质量改进项目无需经过机构审查委员会（IRB）监督。来自代表9个学术机构的腹部放射学会（SAR）肾细胞癌疾病重点小组的13名放射科医生参与了改良的德尔菲法，以创建用于描述CT和MRI上肾肿块影像特征的术语词汇表。在第一轮中，成员们对要纳入的术语和提出的定义进行投票；随后的投票轮次和一次电话会议达成了共识。一名非投票成员编制了问卷并汇总了回复。共识定义为≥80%的同意率。
在37个提议的术语中，6个已达成排除共识。31个术语中的30个（14个基本影像术语中的13个、8个CT术语中的8个、6个MRI术语中的6个以及3个杂项术语中的3个）达成了纳入共识。尽管在第一轮中对“肾肿块”“坏死”“脂肪”和“扩散受限”的定义存在很大的初始分歧，但最终都达成了共识。对于“实性肿块”的定义仍存在分歧。
改良的德尔菲法产生了一个首选术语和定义的词汇表，用于描述CT和MRI上的肾肿块。该词汇表应能提高与肾肿块相关的放射学报告和研究的清晰度和一致性。
