使用基于METastasis前列腺癌报告和数据系统(MET-RADS-P)指南的结构化报告工具,评估放射科医师之间对骨盆多参数磁共振成像(mpMRI)解释的读者共识。
根据MET-RADS-P指南,为晚期前列腺癌(APC)患者的盆腔mpMRI随访制定了结构化报告。总的来说,从2017年12月至2021年2月,对105例APC患者进行了163例成对的盆腔mpMRI检查。这些由两名资深和两名初级放射科医生进行回顾性审查,以检测转移灶,并由这些读者使用主要/次要反应评估类别(RAC)进行分类。有和没有结构化报告。使用Cohen的kappa和加权Cohen的kappa统计(K)评估了关于转移检测和RAC评分的读者共识,分别。
与常规报告(S1:K=0.72;S2:K=0.61)相比,两位资深放射科医师使用结构化报告(S1:K=0.83;S2:K=0.73)与转移检测参考标准的一致性更高。初级放射科医生显示了类似的结果(J1:0.66vs.0.59;J2:0.65vs.0.57)。两位高级放射科医生之间的总体协议对于使用结构化报告的主要RAC模式非常好(K=0.81),对于次要RAC分类(K=0.75)。对于主要和次要RAC值(K=0.76,0.68),两位初级放射科医师的读者共识都很重要。
在放射科医师对APC患者的随访评估中发现了良好的互读协议,其中使用MET-RADS-P指南报告了骨盆mpMRI。这种改进适用于转移性病变检测和定性RAC评估。
To evaluate interreader agreement on pelvic multiparametric magnetic resonance imaging (mpMRI) interpretation among radiologists using a structured reporting tool based on the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) guidelines.
A structured report for follow-up pelvic mpMRI for advanced prostate cancer (APC) patients was formulated based on MET-RADS-P guidelines. In total, 163 paired pelvic mpMRI examinations were performed from December 2017 to February 2021 on 105 patients with APC. These were retrospectively reviewed by two senior and two junior radiologists for metastatic lesion detection and were categorized by these readers using primary/secondary response assessment categories (RACs), with and without the structured report. Interreader agreement regarding metastasis detection and RAC scores was evaluated with Cohen\'s kappa and weighted Cohen\'s kappa statistics (K), respectively.
The two senior radiologists showed higher agreement with the reference standard for metastasis detection using the structured report (S1: K = 0.83; S2: K = 0.73) compared with the conventional report (S1: K = 0.72; S2: K = 0.61). Junior radiologists showed similar results (J1: 0.66 vs. 0.59; J2: 0.65 vs. 0.57). The overall agreement between the two senior radiologists was excellent for the primary RAC pattern using the structured reports (K = 0.81) and was substantial for secondary RAC categorization (K = 0.75). The interreader agreement of the two junior radiologists was substantial for both primary and secondary RAC values (K = 0.76, 0.68).
Good interreader agreement was found for the follow-up assessment of APC patients between radiologists, where the pelvic mpMRI was reported using MET-RADS-P guidelines. This improvement applied to both metastatic lesion detection and qualitative RAC assessment.