2018年LI-RADS版本对MRI和CT的互读器可靠性的多中心评估
Cheng William Hong1, Victoria Chernyak1, Jin-Young Choi1
1From the Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, S255, Box 0628, San Francisco, CA 94143 (C.W.H., M.A.O.); Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, Calif (C.W.H., C.P., T.D., D.T.M., K.J.F., C.B.S.); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (V.C., N.H.); Department of Radiology, Yonsei University, Seoul, South Korea (J.Y.C.); Department of Radiology, University of California Irvine, Orange, Calif (S.L., R.K.); Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, New York University, New York, NY (J.B.); Department of Radiology, University of Florida, Jacksonville, Fla (C.L.); Department of Radiology, University of Kentucky, Lexington, Ky (J.T.L., J.W.O.); Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (D.A.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (M.M.L., M.S.D., W.M.); Department of Radiology, Allegheny Health Network, Pittsburgh, Pa (A.R.); Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (S.C.L.); Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY (A.S.K., E.M.H.); Departments of Radiology and Medicine, Duke University Medical Center, New York, NY (M.R.B.); Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (G.B.); Department of Radiology, University of California Los Angeles, Los Angeles, Calif (M.L.D.); Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, Canada (A.T., M.C.); Department of Radiology, Oregon Health & Science University, Portland, Ore (A.F.); CEDRUL-Centro de Diagnóstico por Imagem, João Pessoa, Brazil (E.A.C.); Department of Radiology, University of California Davis, Sacramento, Calif (M.T.C., J.P.M.); Radiology Limited, Tucson, Ariz (B.K.); Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E., V.R.S., K.B.); Department of Radiology, Naval Medical Center San Diego, San Diego, Calif (R.M.M.); University of São Paulo/Hospital Sírio-Libanês, São Paulo, Brazil (N.H.); Department of Radiology, University of Kansas, Kansas City, Kan (S.B., R.A.); Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, India (K.G.); Department of Radiology, California Pacific Medical Center, San Francisco, Calif (C.R.K.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.K.); The 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (J.W.); Inland Imaging, Spokane, Wash (I.C.); Sutter Medical Group, Sacramento, Calif (B.B.); Austin Health, Melbourne, Australia (M.G.); Department of Radiology, University of Washington, Seattle, Wash (G.M.C.).
肝脏成像报告和数据系统 (LI-RADS) 的读者协议显示了整体中等的结果. 研究对研究读者协议在一些比较中超过了研究对临床协议,这表明环境差异影响评估.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 肝病学 肝病学是一种肝病学.
背景情况:
- 之前关于肝脏成像报告和数据系统 (LI-RADS) 读者协议的研究遇到了局限性.
- 标准化读者协议评估对于可靠的肝损伤表征至关重要.
研究的目的:
- 在国际,多中心,多读者环境中评估LI-RADS读者协议.
- 使用可滚动图像,比较研究读者之间的同意率以及研究和临床读者之间的同意率.
主要方法:
- 来自三个国家的六个机构的多相CT和MRI检查的回顾性分析.
- LI-RADS 2018年版本的分类适用于未经处理的观测,43名研究读者独立评分选定案例.
- 使用顺序和二分化的LI-RADS类别的类内相关系数 (ICC) 计算了协议.
主要成果:
- 对于顺序LI-RADS (ICC=0.68) 和二分化恶性瘤 (ICC=0.63) 观察到中度一致.
- 研究对研究读者一致性显著高于研究对临床一致性对于正规LI-RADS和二分化恶性瘤.
- 对LR-5 (ICC=0.58) 和LR-M (ICC=0.46) 类别的协议显示一致性较低.
结论:
- 2018年LI-RADS版本的读者总体认可度中等.
- 临床和研究环境之间协议的差异凸显了对环境因素进一步调查的需要.
- 标准化培训和图像显示可能会改善临床实践中的LI-RADS一致性.
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