使用 0.08mmol/kg 钆布醇行乳腺 MRI 对癌症分期的准确性和读者间一致性。

Accuracy and inter-reader agreement of breast MRI for cancer staging using 0.08 mmol/kg of gadobutrol.

机构信息

Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.

Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy.

出版信息

Clin Imaging. 2021 Apr;72:154-161. doi: 10.1016/j.clinimag.2020.11.014. Epub 2020 Nov 10.

DOI:10.1016/j.clinimag.2020.11.014

PMID:33249403

Abstract

BACKGROUND

Evidence on gadolinium brain accumulation after contrast-enhanced MRI prompted research in dose reduction.

PURPOSE

To estimate accuracy and inter-reader reproducibility of tumor size measurement in breast MRI using 0.08 mmol/kg of gadobutrol.

METHODS

We retrospectively analyzed all women who underwent 1.5-T breast MRI for cancer staging at our department with 0.08 mmol/kg of gadobutrol. Two readers (R1 and R2, 12 and 3 years-experience) measured the largest lesion diameter. Accuracy was estimated both as correlation with pathology and rate of absolute (>5 mm) overestimation and underestimation, inter-reader reproducibility using the Bland-Altman method. Data are given as median and interquartile range.

RESULTS

Thirty-six patients were analyzed (median age 56 years, 49-66) for a total of 38 lesions, 24 (63%) mass enhancement, 14 (37%) non-mass enhancement. Histopathological median size (mm) of all lesions was 15 (9-25): 13 (9-19) for mass lesions, 19 (11-39) for non-mass lesions. On MRI, R1 measured (mm) 14 (10-22) for all lesions, 13 (10-19) for mass lesions, 19 (11-49) for non-mass lesions. MRI-pathology correlation was very high for all lesion categories (ρ ≥ 0.766). On MRI, R1 overestimated lesion size in 6 cases (16%), and underestimated in 3 (8%); R2, overestimated 7 cases (18%) and underestimated 3 cases (8%). At inter-reader reproducibility analysis (mm): bias 0.9, coefficient of reproducibility 13 for all lesions; -0.1 and 6 for mass lesions; 2.5 and 20 for non-mass lesions.

CONCLUSIONS

Breast MRI may be performed using 0.08 mmol/kg of gadobutrol with high accuracy and acceptable inter-reader agreement.

摘要

背景

对比增强 MRI 后钆在脑内蓄积的证据促使人们开展减少剂量的研究。

目的

评估使用 0.08mmol/kg 钆布醇进行乳腺 MRI 时肿瘤大小测量的准确性和两位读者（R1 和 R2，分别有 12 年和 3 年的经验）的重复性。

方法

我们回顾性分析了在我院使用 0.08mmol/kg 钆布醇进行乳腺癌分期的 1.5-T 乳腺 MRI 的所有女性患者。两位读者（R1 和 R2，分别有 12 年和 3 年的经验）测量了最大病变直径。准确性通过与病理的相关性以及绝对（>5mm）高估和低估的发生率来评估，使用 Bland-Altman 方法评估读者间的可重复性。数据以中位数和四分位距表示。

结果

分析了 36 例患者（中位年龄 56 岁，范围 49-66 岁）的 38 个病灶，24 个（63%）为肿块强化，14 个（37%）为非肿块强化。所有病灶的组织病理学中位大小（mm）为 15（9-25）：肿块病变为 13（9-19），非肿块病变为 19（11-39）。MRI 上，R1 测量的所有病变大小（mm）为 14（10-22），肿块病变为 13（10-19），非肿块病变为 19（11-49）。所有病变类型的 MRI-病理相关性均很高（ρ≥0.766）。MRI 上，R1 高估了 6 个病灶（16%）的病变大小，低估了 3 个病灶（8%）；R2 高估了 7 个病灶（18%），低估了 3 个病灶（8%）。在读者间可重复性分析中（mm）：偏倚为 0.9，所有病变的可重复性系数为 13；肿块病变为-0.1 和 6；非肿块病变为 2.5 和 20。