基于加多的对比介质在诊断时没有改善神经母细胞瘤图像定义风险因素的分期
Cara E Morin1, Reem Hasweh2, Chris Anton1
1Department of Radiology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Pediatric blood & cancer
|October 17, 2023
概括
基于加多的对比介质 (GBCM) 不能提高MRI上神经母细胞瘤分期的准确性. 对比没有改善瘤测量或放射科医生对图像定义的风险因素或儿童转移性疾病的共识.
科学领域:
- 儿科放射学 儿科放射学
- 瘤成像学成像学
- 神经母细胞瘤研究 神经母细胞瘤研究
背景情况:
- 神经母细胞瘤风险分层利用预后和图像定义风险因素 (IDRF).
- 使用基于加多的对比介质 (GBCM) 的磁共振成像 (MRI) 是神经母细胞瘤评估的标准.
- 有关GBCM的不良影响和成本存在担忧,促使对其必要性的调查.
研究的目的:
- 评估静脉注射GBCM对神经母细胞瘤分期观察者间协议的影响.
- 为了确定对比度是否能提高评估瘤大小,IDRF和转移性疾病的准确性.
主要方法:
- 对50名患有神经母细胞瘤的儿童的基线MRI扫描进行了回顾性审查.
- 图像集与没有对比后T1加权序列的比较.
- 四名儿科放射科医生的独立分析评估了瘤大小,IDRF和转移;使用kappa统计数据测量的一致性.
主要成果:
- 在前对比度和后对比度MRI之间对瘤大小测量有很好的一致性.
- 对IDRFs和转移性疾病的观察者间协议显示,无论对比度如何,差距很小或实质性一致.
- 对IDRFs的总体一致性是与对比度 (kappa=0.63) 相当的,而没有对比度 (kappa=0.5) 则适度,有重叠的置信区间.
- 对转移性疾病的总体一致性与对比度相当 (kappa=0.49) 和没有对比度的中度 (kappa=0.71).
结论:
- 静脉注射GBCM并不能改善儿科神经母细胞瘤中的瘤大小测量.
- 对比剂的使用不会提高放射科医生对IDRF或转移性疾病存在的共识.
- 结果表明对比可能不必用于基线神经母细胞瘤分期MRI.
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