在乳腺癌中进行标准化淋巴结评估的MRI性能:我们准备好了Node-RADS吗?
Federica Pediconi1, Roberto Maroncelli2, Marcella Pasculli1
1Department of Radiological, Oncological, and Pathological Sciences, Sapienza-University of Rome, 00185, Rome, Italy.
European radiology
|June 12, 2024
概括
节点-RADS评分准确地预测了使用MRI的乳腺癌患者的淋巴结入侵. 节点-RADS分数大于2是识别恶性节点和指导治疗决策的最佳.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 淋巴结入侵 (LNI) 对乳腺癌 (BC) 阶段和治疗至关重要.
- 为了准确诊断,需要对LNI进行标准化的评估.
- 节点-RADS评分是为BC的标准化淋巴结评估而开发的.
研究的目的:
- 评估Node-RADS得分的诊断性能,用于预测使用MRI的BC患者的LNI.
- 在三个放射科医生之间评估Node-RADS得分的读者间协议.
- 为了确定最佳的节点-RADS切断值来区分恶性淋巴结.
主要方法:
- 对192名BC患者进行回顾性分析,这些患者接受了手术前的MRI和淋巴结解剖.
- 计算各种节点-RADS截止值的灵敏度,特异性,PPV和NPV.
- 接收器运行特征 (ROC) 曲线分析和科恩的卡帕对读者之间的协议.
主要成果:
- 节点-RADS在预测LNI时表现出中高精度.
- 特异性和PPV随着Node-RADS截止值的提高而增加,在Node-RADS> 2时达到100%.
- 观察到优异的读者间一致性 (卡帕:0.71-0.83) 和高的AUC值 (0.93-0.97).
结论:
- 节点-RADS评分是通过MRI评估BC患者的LNI的可靠工具.
- 对于识别恶性淋巴结,建议节点-RADS切断值>2.
- 这种标准化的评分系统可以提高BC的诊断准确性和治疗计划.
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