常染色体显性多囊肾病患者全肾体积测量标准化指令的准确性、可重复性和用户体验。
Accuracy, Reproducibility and User Experience With Standardized Instructions for Measurement of Total Kidney Volume in Autosomal Dominant Polycystic Kidney Disease.
机构信息
Division of Nephrology, 12358University of British Columbia, Vancouver, BC, Canada.
157786BC Renal, Vancouver, BC, Canada.
出版信息
Can Assoc Radiol J. 2023 May;74(2):343-350. doi: 10.1177/08465371221124120. Epub 2022 Sep 5.
PURPOSE
Total kidney volume (TKV) measurement is integral in clinical management of autosomal dominant polycystic kidney disease (ADPKD) but the gold standard of measurement via stereology/manual planimetry is time-consuming and not readily available to clinicians. This study assessed whether standardized measurement instructions based on an ellipsoid equation enhanced TKV assessment on computed tomographic (CT) images of the kidneys as determined by accuracy, reproducibility, efficiency and/or user acceptability.
METHODS
Participating radiologists were randomized to perform TKV measurements with or without standardized instructions. All participants measured the same 3 non-contrast, low-dose CT scans. Accuracy was assessed as variation from TKV measurements obtained by planimetry. Intraclass correlation coefficients and time to complete the measurements were assessed. Surveys assessed prior experience with TKV measurement and user acceptability of the instructions.
RESULTS
49 radiologists participated. There was no difference in accuracy or measurement time between instructed and non-instructed participants. There was a trend towards greater reproducibility with standardized instructions (ICC .8 vs .6). 92% of respondents indicated the instructions were easy to use, 86% agreed the instructions would enhance their comfort with TKV measurement and 75% agreed they would recommend these instructions to colleagues.
CONCLUSIONS
Instructed and non-instructed participants demonstrated similar accuracy and time required for TKV measurement, but instructed participants had a trend towards greater reproducibility. There was high acceptability including enhanced user confidence with the instructions. Standardized instructions may be of value for radiologists seeking to improve their confidence in providing clinicians with TKV measurements necessary to appropriately manage this patient population.
目的
全肾体积（TKV）测量是常染色体显性多囊肾病（ADPKD）临床管理的重要组成部分，但通过体视学法/手动平面测量法进行测量的金标准既耗时又不能为临床医生所轻易获得。本研究评估了基于椭圆方程的标准化测量说明是否增强了对肾脏 CT 图像的 TKV 评估，其评估指标包括准确性、可重复性、效率和/或用户接受度。
方法
参与的放射科医生被随机分配进行 TKV 测量，分为有标准化说明和无标准化说明两种情况。所有参与者都测量了相同的 3 次非对比、低剂量 CT 扫描。准确性通过与平面测量法获得的 TKV 测量值的差异来评估。评估了组内相关系数和完成测量所需的时间。调查评估了参与者之前进行 TKV 测量的经验以及对说明的用户接受度。
结果
49 名放射科医生参与了研究。有标准化说明和无标准化说明的参与者在准确性或测量时间方面没有差异。有标准化说明的参与者在可重复性方面有改善的趋势（ICC.8 比.6）。92%的受访者表示说明易于使用，86%的人同意说明将增强他们对 TKV 测量的舒适度，75%的人同意将向同事推荐这些说明。
结论
有标准化说明和无标准化说明的参与者在 TKV 测量的准确性和所需时间方面表现相似，但有标准化说明的参与者在可重复性方面有改善的趋势。说明具有很高的可接受性，包括增强了用户对说明的信心。对于寻求增强对向临床医生提供 TKV 测量的信心的放射科医生来说，标准化说明可能具有价值，这对于适当管理该患者群体是必要的。
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