四个肝细胞癌诊断指南的比较使用加多克西酸增强肝脏MRI
Jeong Hee Yoon1, Young Kon Kim1, Jeong Woo Kim1
1From the Department of Radiology, Seoul National University Hospital & College of Medicine, Seoul 03080, Republic of Korea (J.H.Y., J.M.L.); Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (Y.K.K.); Department of Radiology, Korea University Guro Hospital & College of Medicine, Seoul, Republic of Korea (J.W.K., C.H.L.); Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (W.C.); Department of Radiology, Seoul Saint Mary's Hospital & College of Medicine, Catholic University of Korea, Seoul, Republic of Korea (J.I.C.); Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea (B.J.P.); Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (J.Y.C., S.K.); Department of Radiology, Konkuk University School of Medicine, Seoul, Republic of Korea (H.S.P.); Department of Radiology, Chung-Ang University Hospital, Seoul, Republic of Korea (E.S.L.); Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (J.S.Y.); Department of Radiology, Kyung Hee University College of Medicine and Kyung Hee University Hospital, Seoul, Republic of Korea (S.J.P., M.W.Y.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (J.M.L.).
通过使用加达酸增强型MRI诊断肝细胞癌 (HCC) 的四个国际指南进行比较,韩国肝癌协会-国家癌症中心 (KLCA-NCC) 的指南显示了最高的准确性. 读者判断超越了指导方针的表现,强调了专家解释在HCC诊断中的重要性.
科学领域:
- 放射学 放射学是一门学科.
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
背景情况:
- 肝细胞癌 (HCC) 的非侵入性诊断指南在全球范围内有所不同,特别是关于加达克西酸增强的MRI标准.
- 这种变化影响了诊断准确性和HCC的患者管理,这是癌症死亡的主要原因.
研究的目的:
- 将四个国际HCC诊断指南的诊断性能与专家读者的判断进行比较.
- 在高风险患者中使用 gadoxetic 酸增强的MRI 评估 HCC 诊断.
主要方法:
- 从韩国11家医院的2237名高风险患者的 gadoxetic 酸增强的MRI扫描的回顾性分析.
- 四名放射科医生使用AASLD/LI-RADS,KLCA-NCC,EASL和APASL指南独立评估了焦点肝损伤 (FLL).
- 诊断性能指标包括准确性,敏感性,特异性和诊断几率比率进行了比较. 读者判断也被记录下来.
主要成果:
- 韩国肝癌协会-国家癌症中心 (KLCA-NCC) 准则显示了最高的准确性 (80.0%).
- 东方指南 (APASL,KLCA-NCC) 显示出更高的敏感性,而西方指南 (AASLD/LI-RADS,EASL) 显示出更高的特异性.
- 与所有评估的指南相比,读者判断获得了更高的准确性 (86.0%).
结论:
- 东方和西方的指导方针在MRI的HCC诊断中提供了互补的优势,东方的指导方针在敏感性方面表现出色,而西方的指导方针在特异性方面表现出色.
- 在评估的国际标准中,KLCA-NCC指南提供了最好的整体准确性.
- 个人放射科医生的解释仍然至关重要,在HCC的诊断准确性方面表现优于既定指南.
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