西方人群中用于肝细胞癌早期复发监测的肝脏非增强简化磁共振成像的可重复性和准确性：一项多阅片者研究
Reproducibility and accuracy of non-contrast abbreviated magnetic resonance imaging of the liver in surveillance for early recurrence for hepatocellular carcinoma in a Western population: a multi-reader study.
作者信息
Rimola Jordi, Saborido Belén, Igual Alba, Roca Andreu, Darnell Anna, Jiménez Sergio, Mesa Alicia, Navarro Vicente, Soler Alexandre, Ayuso Carmen, Reig María
机构信息
BCLC Group, Radiology Department, Hospital Clínic de Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.
出版信息
Abdom Radiol (NY). 2025 Jul 9. doi: 10.1007/s00261-025-05105-5.
PURPOSE
Abbreviated MRI (AMRI) protocols may represent an alternative to conventional MRI (CMRI) for surveillance of hepatocellular carcinoma (HCC). We aimed to compare the inter-reader agreement and sensitivity of AMRI versus CMRI for HCC recurrence < 2 years after curative ablation in at risk-population.
METHODS
Eight radiologists (4 with < 5 years' and 4 with ≥ 5 years' experience) from three institutions reviewed a retrospective serie of 143 CMRI and AMRI from 75 cirrhotic patients (84% HCV and/or alcohol-related) undergoing secondary screening after HCC ablation in a blinded and independent manner, with imaging assessments separated by 1-3 month. We calculated the intra and inter-reader agreement by means Gwet's AC1 for detection of local recurrence at the ablation site, new intrahepatic, and any type of recurrence (either local and/or new intrahepatic) with CMRI and AMRI. Reference diagnoses of recurrent HCC were based on histological or imaging-based criteria.
RESULTS
Early HCC recurrence was detected in 37 (49.3%), including 12 local recurrence, 21 new intrahepatic lesions, 4 had both local recurrence and new intrahepatic lesions. Inter-reader agreement was similarly high for AMRI and CMRI for local recurrence [0.87 (0.83‒0.90) vs. 0.87 (0.83‒0.92)], but higher for AMRI than for CMRI for new intrahepatic [0.85 (0.81‒0.9) vs. 0.6 (0.52‒0.67)] and any type [0.73 (0.67‒0.78) vs. 0.56 (0.49‒0.64)] recurrences. Sensitivity for detecting any type of HCC recurrence was higher for CMRI [0.83 (0.78‒0.87) vs. 0.39 (0.33‒0.45) for AMRI, p < 0.0001].
CONCLUSIONS
Compared to CMRI, non-contrast AMRI showed higher inter-observed agreement but with very low sensitivity for early detection of HCC recurrence in a cohort with predominantly HCV and/or alcohol related cirrhosis, making it not suitable for this purpose.
目的
简化磁共振成像（AMRI）方案可能是监测肝细胞癌（HCC）的传统磁共振成像（CMRI）的一种替代方法。我们旨在比较AMRI与CMRI在高危人群中对根治性消融术后<2年HCC复发的阅片者间一致性和敏感性。
方法
来自三个机构的八名放射科医生（4名经验<5年，4名经验≥5年）以盲法和独立方式回顾了75例肝硬化患者（84%为丙型肝炎病毒和/或酒精相关）在HCC消融术后进行二次筛查的143例CMRI和AMRI的回顾性系列影像，影像评估间隔1 - 3个月。我们通过Gwet's AC1计算阅片者内和阅片者间对消融部位局部复发、新的肝内复发以及CMRI和AMRI任何类型复发（局部和/或新的肝内复发）的一致性。复发性HCC的参考诊断基于组织学或影像学标准。
结果
在37例（49.3%）中检测到早期HCC复发，包括12例局部复发、21例新的肝内病变、4例既有局部复发又有新的肝内病变。AMRI和CMRI对局部复发的阅片者间一致性同样高[0.87（0.83 - 0.90）对0.87（0.83 - 0.92）]，但AMRI对新的肝内复发[0.85（0.81 - 0.9）对0.6（0.52 - 0.67）]和任何类型复发[0.73（0.67 - 0.78）对0.56（0.49 - 0.64）]的一致性高于CMRI。CMRI检测任何类型HCC复发的敏感性更高[0.83（0.78 - 0.87）对AMRI的0.39（0.33 - 0.45），p < 0.0001]。
结论
与CMRI相比，非增强AMRI显示出更高的观察者间一致性，但在以丙型肝炎病毒和/或酒精相关肝硬化为主的队列中对HCC复发的早期检测敏感性非常低，使其不适合用于此目的。
Zotero 插件