PI-QUAL 评分在多中心环境中的读者间可变性和可重复性。
Inter-reader variability and reproducibility of the PI-QUAL score in a multicentre setting.
机构信息
Joint Department of Medical Imaging, University Medical Imaging Toronto; University Health Network-Mount Sinai Hospital-Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Joint Department of Medical Imaging, University Medical Imaging Toronto; University Health Network-Mount Sinai Hospital-Women's College Hospital, University of Toronto, Toronto, ON, Canada. Electronic address: https://twitter.com/AdrianoDiasRad.
出版信息
Eur J Radiol. 2023 Nov;168:111091. doi: 10.1016/j.ejrad.2023.111091. Epub 2023 Sep 9.
PURPOSE
To assess the inter-reader reproducibility of the Prostate Imaging Quality (PI-QUAL) score between readers with varying clinical experience and its reproducibility at assessing imaging quality between different institutions.
METHODS
Following IRB approval, we assessed 60 consecutive prostate MRI scans performed at different academic teaching and non-academic hospitals uploaded to our institutes' PACS for second opinion or discussion in case conferences. Anonymized scans were independently reviewed using the PI-QUAL scoring sheet by three readers - two radiologists (with 1 and 12 years Prostate MRI reporting experience), and an experienced MRI technician with interest in image acquisition and quality. All readers were blinded to the site where scans were acquired.
RESULTS
Agreement coefficients between the 3 readers in paired comparison for each individual PI-QUAL score was moderate. When the scans were clustered into 2 groups according to their ability to rule in or rule out clinically significant prostate cancer [i.e., PI-QUAL score 1-3 vs PI-QUAL score 4-5], the Gwet AC1 coefficients between the three readers in paired comparison was good to very good [Gwet AC 1:0.77, 0.67, 0.836 respectively] with agreement percentage of 88.3%, 83.3% and 91.7% respectively. Agreement coefficient was higher between the experienced radiologist and the experienced MRI technician than between the less experienced trainee radiologist and the other two readers. The mean PI-QUAL score provided by each reader for the scans was significantly higher in the academic hospitals (n = 32) compared to the community hospital (n = 28) [experienced radiologist 4.6 vs 2.9; trainee radiologist 4.5 vs 2.4; experienced technologist 4.4 vs 2.4; p value < 0.001].
CONCLUSION
We observed good to very good reproducibility in the assessment of each MRI sequence and when scans were clustered into two groups [PI-QUAL 1-3 vs PI-QUAL 4-5] between readers with varying clinical experience. However, the reproducibility for each single PI-QUAL score between readers was moderate. Better definitions for each PI-QUAL score criteria may further improve reproducibility between readers. Additionally, the mean PI-QUAL score provided by all three readers was significantly higher for scans performed at academic teaching hospitals compared to community hospital.
目的
评估具有不同临床经验的读者之间前列腺成像质量（PI-QUAL）评分的读者间可重复性及其在评估不同机构之间成像质量的可重复性。
方法
在获得机构审查委员会批准后，我们评估了 60 例连续的前列腺 MRI 扫描，这些扫描是在不同的学术教学医院和非学术教学医院进行的，上传到我们机构的 PACS 中，以便在病例会议中进行二次诊断或讨论。三位读者（两位具有 1 年和 12 年前列腺 MRI 报告经验的放射科医生，以及一位对图像采集和质量感兴趣的经验丰富的 MRI 技师）使用 PI-QUAL 评分表对匿名扫描进行独立评估。所有读者均对扫描采集地点不知情。
结果
三位读者在对每个单独的 PI-QUAL 评分进行配对比较时，一致性系数为中度。当根据是否能够排除临床显著前列腺癌的能力将扫描分为两组（即 PI-QUAL 评分 1-3 与 PI-QUAL 评分 4-5）时，三位读者在配对比较中的 Gwet AC1 系数为良好至非常好[Gwet AC1：分别为 0.77、0.67 和 0.836]，一致性百分比分别为 88.3%、83.3%和 91.7%。经验丰富的放射科医生和经验丰富的 MRI 技师之间的一致性系数高于经验较少的放射科医生和其他两位读者之间的一致性系数。每位读者对学术医院（n=32）的扫描提供的平均 PI-QUAL 评分明显高于社区医院（n=28）[经验丰富的放射科医生 4.6 比 2.9；培训放射科医生 4.5 比 2.4；经验丰富的技师 4.4 比 2.4；p 值均<0.001]。
结论
我们观察到，具有不同临床经验的读者之间在评估每个 MRI 序列以及将扫描分为两组[PI-QUAL 1-3 与 PI-QUAL 4-5]时具有良好至非常好的可重复性。然而，读者之间对每个单独的 PI-QUAL 评分的可重复性为中度。进一步改善读者之间的可重复性可能需要更好地定义每个 PI-QUAL 评分标准。此外，所有三位读者对学术教学医院的扫描提供的平均 PI-QUAL 评分明显高于社区医院。
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