Cox Veronica, Haddad Antony, Lendoire Mateo, Yedururi Sireesha, Marcal Leonardo, Panettieri Elena, Kawaguchi Yoshikuni, Bassett Roland, Vauthey Jean-Nicolas, Kang Hyunseon C
Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, 77030-4009, USA.
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
Ann Surg Oncol. 2025 Jul 16. doi: 10.1245/s10434-025-17790-z.
This study aimed to quantify the value of imaging second review and multidisciplinary discussion of cases presented at the hepatobiliary tumor board (HTB) at a comprehensive cancer center.
Cases referred to HTB for review and discussion during approximately 20 months were prospectively collected and characterized according to referral information, revisions to imaging findings, original management plan (before HTB), and final management plan (after HTB). Accuracy of original imaging interpretations versus revisions was determined, mostly by follow-up imaging.
For 50 (34.2 %) of 147 patients, hepatobiliary group radiologists (HBRs) performed revisions of original imaging interpretations. In consequence of imaging revision, the management plan was changed for 19 (12.9 %) patients. Revision rates were higher for reports initially read by abdominal radiologists (ARs) than for reports read by HBRs (41.5 % vs 20.8 %; p = 0.011). Imaging reads related to cholangiocarcinoma and colorectal liver metastases (CLM) cases were the most frequently revised (12.2 % vs 8.2 % of all cases brought to conference). Management changes related to revisions occurred most frequently in CLM cases (58.3 %). Imaging revisions improved accuracy by 27.9 %. In 38.8 % of all cases, HBT discussion changed management. The most common reason for the change was interventional radiology or radiation oncology input (28.1 %). The vast majority of the time (95.1 %) questions brought to HTB by clinicians could be answered using available imaging.
Imaging review by hepatobiliary radiologists and multidisciplinary discussion at HTB increases diagnostic accuracy of reads and results in management change for more than one third of patients.
本研究旨在量化在一家综合癌症中心的肝胆肿瘤委员会（HTB）上对病例进行影像二次评估和多学科讨论的价值。
前瞻性收集了在大约20个月内提交至HTB进行评估和讨论的病例，并根据转诊信息、影像结果的修订、初始管理计划（HTB之前）和最终管理计划（HTB之后）进行特征描述。主要通过随访影像确定初始影像解读与修订之间的准确性。
在147例患者中，有50例（34.2%）患者的肝胆组放射科医生（HBRs）对初始影像解读进行了修订。由于影像修订，19例（12.9%）患者的管理计划发生了改变。腹部放射科医生（ARs）最初阅读的报告的修订率高于HBRs阅读的报告（41.5%对20.8%；p = 0.011）。与胆管癌和结直肠癌肝转移（CLM）病例相关的影像解读是最常被修订的（占提交至会议的所有病例的12.2%对8.2%）。与修订相关的管理改变在CLM病例中最常发生（58.3%）。影像修订使准确性提高了27.9%。在所有病例的38.8%中，HBT讨论改变了管理。改变的最常见原因是介入放射学或放射肿瘤学的意见（28.1%）。临床医生提交至HTB的问题绝大多数时候（95.1%）可以通过现有的影像来回答。
肝胆放射科医生进行的影像评估以及HTB的多学科讨论提高了解读的诊断准确性，并导致超过三分之一的患者管理发生改变。
