使用前列腺癌 METastasis Reporting and Data System 指南分析盆腔多参数磁共振成像结构报告的读者间一致性。
Analysis of interreader agreement in structured reports of pelvic multiparametric magnetic resonance imaging using the METastasis Reporting and Data System for Prostate Cancer guidelines.
机构信息
Department of Radiology, Peking University First Hospital, Beijing, China.
Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China.
出版信息
Diagn Interv Radiol. 2023 Jan 31;29(1):29-39. doi: 10.5152/dir.2022.211232. Epub 2023 Jan 17.
PURPOSE
To evaluate interreader agreement on pelvic multiparametric magnetic resonance imaging (mpMRI) interpretation among radiologists using a structured reporting tool based on the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) guidelines.
METHODS
A structured report for follow-up pelvic mpMRI for advanced prostate cancer (APC) patients was formulated based on MET-RADS-P guidelines. In total, 163 paired pelvic mpMRI examinations were performed from December 2017 to February 2021 on 105 patients with APC. These were retrospectively reviewed by two senior and two junior radiologists for metastatic lesion detection and were categorized by these readers using primary/secondary response assessment categories (RACs), with and without the structured report. Interreader agreement regarding metastasis detection and RAC scores was evaluated with Cohen's kappa and weighted Cohen's kappa statistics (K), respectively.
RESULTS
The two senior radiologists showed higher agreement with the reference standard for metastasis detection using the structured report (S1: = 0.83; S2: = 0.73) compared with the conventional report (S1: = 0.72; S2: = 0.61). Junior radiologists showed similar results (J1: 0.66 vs. 0.59; J2: 0.65 vs. 0.57). The overall agreement between the two senior radiologists was excellent for the primary RAC pattern using the structured reports ( = 0.81) and was substantial for secondary RAC categorization ( = 0.75). The interreader agreement of the two junior radiologists was substantial for both primary and secondary RAC values ( = 0.76, 0.68).
CONCLUSION
Good interreader agreement was found for the follow-up assessment of APC patients between radiologists, where the pelvic mpMRI was reported using MET-RADS-P guidelines. This improvement applied to both metastatic lesion detection and qualitative RAC assessment.
目的
评估使用基于前列腺癌转移报告和数据系统（MET-RADS-P）指南的结构化报告工具对高级前列腺癌（APC）患者进行盆腔多参数磁共振成像（mpMRI）解读的放射科医生之间的读者间一致性。
方法
根据 MET-RADS-P 指南制定了用于 APC 患者随访盆腔 mpMRI 的结构化报告。总共对 105 名 APC 患者进行了 163 对盆腔 mpMRI 检查，这些检查于 2017 年 12 月至 2021 年 2 月进行。由两名高级和两名初级放射科医生对转移性病变进行回顾性检查，并使用主要/次要反应评估类别（RAC）对这些读者进行分类，有无结构化报告。使用 Cohen's kappa 和加权 Cohen's kappa 统计量（K）分别评估转移性病变检测和 RAC 评分的读者间一致性。
结果
与传统报告相比（S1： = 0.72；S2： = 0.61），两位高级放射科医生使用结构化报告进行转移检测时与参考标准的一致性更高（S1： = 0.83；S2： = 0.73）。初级放射科医生的结果相似（J1：0.66 与 0.59；J2：0.65 与 0.57）。两位高级放射科医生使用结构化报告进行主要 RAC 模式的总体一致性为优秀（ = 0.81），而对次要 RAC 分类的一致性为良好（ = 0.75）。两位初级放射科医生对主要和次要 RAC 值的读者间一致性均为良好（ = 0.76，0.68）。
结论
在使用 MET-RADS-P 指南报告盆腔 mpMRI 时，放射科医生对 APC 患者的随访评估显示出良好的读者间一致性。这种改进适用于转移性病变检测和定性 RAC 评估。
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