使用 VI-RADS 比较小视野 DWI 与全视野 DWI 对非肌层浸润性膀胱癌和肌层浸润性膀胱癌的鉴别诊断。
Comparison of reduced field-of-view DWI and full field-of view DWI for the differentiation between non-muscle invasive bladder cancer and muscle invasive bladder cancer using VI-RADS.
机构信息
Department of Diagnostic Radiology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Department of Health Care, Osaka Medical Association Center, Osaka, Japan.
出版信息
PLoS One. 2022 Jul 20;17(7):e0271470. doi: 10.1371/journal.pone.0271470. eCollection 2022.
PURPOSE
To evaluate whether reduced field-of-view (rFOV) DWI sequence improves the differentiation between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) using VI-RADS.
MATERIAL AND METHODS
Eighty-nine patients underwent bladder MRI with full field-of-view (fFOV) DWI and rFOV DWI sequence. Images were independently evaluated by 2 radiologists. The sensitivities, specificities, accuracies, and areas under the curve (AUCs) for the differentiation between NMIBC and MIBC with fFOV DWI and with rFOV DWI sequence were calculated using VI-RADS. Apparent diffusion coefficients (ADC) values were measured for each patient and averaged.
RESULTS
The sensitivity, specificity, accuracy, and AUC by reader 1 were 92%, 78%, 82% and 0.905 with fFOV DWI, and 92%, 86%, 88% and 0.916 with rFOV DWI sequence, respectively. The sensitivity, specificity, accuracy and AUC by reader 2 were 96%, 76%, 82% and 0.900 with conventional DWI, and 96%, 81%, 85% and 0.907 with rFOV DWI sequence, respectively. The specificity and accuracy of reader 1 were significantly better with rFOV DWI sequence than with fFOV DWI, in contrast there was no significant difference for the others. The average of ADC values of fFOV DWI and rFOV DWI sequence were 1.004×10-6 mm2/s and 1.003×10-6 mm2/s, respectively.
CONCLUSION
The diagnostic ability of rFOV DWI sequence may be better than that of fFOV DWI using VI-RADS for the differentiation between NMIBC and MIBC regardless of image-reading experience, it is controversial.
目的
使用 VI-RADS 评估小视野（rFOV）DWI 序列是否可提高非肌层浸润性膀胱癌（NMIBC）与肌层浸润性膀胱癌（MIBC）的鉴别诊断能力。
材料与方法
89 例患者行膀胱 MRI 检查，包括全视野（fFOV）DWI 和 rFOV DWI 序列。2 位放射科医生独立对图像进行评估。使用 VI-RADS 计算 fFOV DWI 和 rFOV DWI 序列鉴别 NMIBC 和 MIBC 的敏感度、特异度、准确度和曲线下面积（AUC）。测量每位患者的表观扩散系数（ADC）值并取平均值。
结果
读者 1 采用 fFOV DWI 的敏感度、特异度、准确度和 AUC 分别为 92%、78%、82%和 0.905，采用 rFOV DWI 序列分别为 92%、86%、88%和 0.916。读者 2 采用常规 DWI 的敏感度、特异度、准确度和 AUC 分别为 96%、76%、82%和 0.900，采用 rFOV DWI 序列分别为 96%、81%、85%和 0.907。与 fFOV DWI 相比，rFOV DWI 序列的特异度和准确度均显著提高，而其他参数无显著差异。fFOV DWI 和 rFOV DWI 序列的 ADC 值平均值分别为 1.004×10-6mm2/s 和 1.003×10-6mm2/s。
结论
使用 VI-RADS，rFOV DWI 序列在区分 NMIBC 和 MIBC 方面的诊断能力可能优于 fFOV DWI，但其诊断效能是否与读图经验有关仍存在争议。
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