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观察者间的变化和诊断性能在预测胰腺导管内皮质粘性新生体的恶性瘤与MRI

Seo-Youn Choi¹, Ji Hye Min¹, Jung Hoon Kim¹

¹From the Departments of Radiology (S.Y.C.) and Biostatistics, Clinical Trial Center (J.E.M.), Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea; Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea (J.H.M., J.H.L.); Department of Radiology and Research Institute of Radiological Science, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea (J.H.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea (H.J.P.); Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (Y.Y.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (Y.E.H.); Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea (S.H.B.); and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Republic of Korea (Y.H.C.).

|July 25, 2023

概括

2017年胰腺导管内 papillary 粘膜瘤 (IPMN) 的指导方针显示,对高风险的污名的MRI诊断性能良好. 经验丰富的放射科医生达成更好的协议,但令人担忧的特征显示解释不那么一致.

科学领域:

胃肠病学和肝病学
放射学和成像学放射学和成像学
在瘤学瘤学.

背景情况:

2017年国际共识指南已被广泛采用,用于管理胰腺内导管内皮质粘膜瘤 (IPMN).
准确评估IPMN恶性瘤潜力对于患者管理和治疗决策至关重要.

研究的目的:

评估放射科医生在使用MRI评估IPMN的不同经验水平之间的观察者间协议.
根据2017年指南,确定MRI在预测恶性IPMN的诊断性能.

主要方法:

对100名患有病理学证明的胰腺IPMN的患者进行了回顾性多中心研究,这些患者接受了对比度增强的MRI.
八名研究生后放射科医生 (4名经验丰富,4名经验不够丰富) 根据2017年指导方针对高风险的污名和令人担忧的特征进行了MRI评估.
使用Fleiss κ统计数据分析观察者间协议;通过ROC曲线分析评估诊断性能.

主要成果:

对于高风险的伤痕 (例如,主要胰腺管的大小≥10毫米,增强壁状结节≥5毫米) 观察者之间观察到实质性的一致性.
对于令人担忧的特征,人们注意到相当或实质性的一致性,更有经验的放射科医生对高风险的印表现出更好的一致性.
预测恶性IPMN的整体诊断性能很好 (AUC范围为0.77-0.84),与实质一致 (κ=0.76).

结论:

2017年的指导方针促进了良好的诊断性能和通过MRI检测恶性IPMN的高风险标记的实质性观察者间协议.
关于令人担忧的特征,观察者之间的共识不那么一致,突出了指导方针改进的潜在领域.
放射科医生的经验对评估胰腺IPMN的高风险标志物有积极的影响.

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