Mohammadzadeh Saeed, Mohebbi Alisa, Abdi Ali, Mohammadi Afshin
Universal Scientific Education and Research Network (USERN), Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
BMC Med Imaging. 2025 May 3;25(1):148. doi: 10.1186/s12880-025-01688-z.
To evaluate the reproducibilities of Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) for hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) using contrast-enhanced computed tomography (CT).
This retrospective study included 105 consecutive patients with confirmed HCC recruited from November 2002 to June 2012. The study protocol has been pre-registered at ( https://osf.io/nxg4q/ ) on the Open Science Framework (OSF) platform. Patients with pre-procedural and follow-up CT scans who had solely received TACE were included. The tumor response evaluation to TACE was conducted using RECIST 1.1 and mRECIST guidelines. Three experienced board-certified abdominal radiologists interpreted CT scans.
For pre-procedure CT, the agreement was more excellent when using RECIST guidelines with a "marginally significant" p-value of 0.056. This trend continued for post-procedural CT scans, with RECIST again showing significantly higher agreement with a p-value of 0.001. When evaluating the four categories of response, Gwet's coefficient was 0.90 (CI = 0.83 to 0.97) for RECIST and 0.80 (CI = 0.63 to 0.90) for mRECIST. Conversely, the Fleiss Kappa analysis demonstrated a higher agreement for the mRECIST guideline. There was an insignificant difference in RECIST and mRECIST guidelines inter-reader agreement when categorizing the tumor response with a p-value of 0.101.
Both guidelines' inter-reader reproducibility in assessing tumor response through CT after the TACE procedure was excellent, with RECIST's reproducibility being very slightly better.
使用对比增强计算机断层扫描（CT）评估实体瘤疗效评价标准（RECIST）和改良RECIST（mRECIST）对经动脉化疗栓塞（TACE）治疗的肝细胞癌（HCC）患者的可重复性。
这项回顾性研究纳入了2002年11月至2012年6月连续入选的105例确诊HCC患者。该研究方案已在开放科学框架（OSF）平台（https://osf.io/nxg4q/）上进行了预注册。纳入仅接受过TACE治疗且有术前和术后CT扫描的患者。使用RECIST 1.1和mRECIST指南对TACE的肿瘤反应进行评估。三位经验丰富的经委员会认证的腹部放射科医生解读CT扫描结果。
对于术前CT，使用RECIST指南时一致性更佳，“边缘显著”的p值为0.056。术后CT扫描也呈现这一趋势，RECIST再次显示出显著更高的一致性，p值为0.001。在评估四类反应时，RECIST的Gwet系数为0.90（CI = 0.83至0.97），mRECIST为0.80（CI = 0.63至0.90）。相反，Fleiss Kappa分析显示mRECIST指南的一致性更高。在对肿瘤反应进行分类时，RECIST和mRECIST指南的阅片者间一致性差异不显著，p值为0.101。
两种指南在通过TACE术后CT评估肿瘤反应时阅片者间的可重复性均极佳，RECIST的可重复性略好。
