对于临床上显著的前列腺癌检测PI-RADS v2.1评分的准确性,内部和放射科医生间的变异性
Haibo Ren1,2, Yun Peng1,2, Yixin Si1,2
1Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Quantitative imaging in medicine and surgery
|August 11, 2025
概括
前列腺成像报告和数据系统版本2.1 (PI-RADS v2.1) 有效地识别出临床显著的前列腺癌 (PCa). 然而,放射科医生之间的一致性很差,这凸显了PI-RADS评估中需要提高标准化的需要.
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:
- 前列腺成像报告和数据系统版本2.1 (PI-RADS v2.1) 是前列腺癌评估的标准.
- 不确定性存在于不同机构的放射科医生之间的PI-RADS v2.1评分和分类的一致性.
研究的目的:
- 评估PI-RADS v2.1在区分临床显著前列腺癌 (PCa) 与非显著病变方面的准确性.
- 评估PI-RADS v2.1评分和分类的观察者内部和观察者间的一致性.
主要方法:
- 对164名前列腺MRI和活检确认的患者的回顾性分析.
- 来自5个机构的6名放射科医生使用PI-RADS v2.1标准对病变的独立评估.
- 评估T2加权成像 (T2WI) 评分,扩散加权成像 (DWI) 评分和PI-RADS类别.
- 使用kappa和肯德尔的W系数评估观察者内部和观察者间的协议.
主要成果:
- 在放射科医生中,PCa识别曲线下的面积 (AUC) 值从0.833到0.915不等.
- 发现PI-RADS 3和4病变中很大一部分病变不显著 (分别为61.3-91.9%和18.2-45.6%).
- 对T2WI,DWI和PI-RADS类别的观察者内部协议 (kappa系数) 从0.408到0.763不等.
结论:
- PI-RADS v2.1 是有效的诊断临床显著的PCa.
- 相当多的PI-RADS 3-4病变是无意义的,这表明过度检测的可能性.
- 观察者内部可复制性中度至实质性,但放射科医生之间的一致性通常很差,除了高级放射科医生中DWI分数外.
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