Interobserver Variability and Accuracy of Preoperative CT and MRI in Pancreatic Ductal Adenocarcinoma Size Estimation: A Retrospective Cohort Study.

Autor:	Cocquempot R; Department of Radiology, Hopital Cochin, AP-HP, Paris, France.; Faculté de Médecine, Université Paris Cité, Paris, France., Bonnin A; Department of Radiology, Hopital Cochin, AP-HP, Paris, France., Barat M; Department of Radiology, Hopital Cochin, AP-HP, Paris, France.; Faculté de Médecine, Université Paris Cité, Paris, France., Naveendran G; Department of Digestive, Hepatobiliary and Endocrine Surgery, Hopital Cochin, AP-HP, Paris, France., Dohan A; Department of Radiology, Hopital Cochin, AP-HP, Paris, France.; Faculté de Médecine, Université Paris Cité, Paris, France., Fuks D; Faculté de Médecine, Université Paris Cité, Paris, France.; Department of Digestive, Hepatobiliary and Endocrine Surgery, Hopital Cochin, AP-HP, Paris, France., Terris B; Faculté de Médecine, Université Paris Cité, Paris, France.; Department of Pathology, Hopital Cochin, AP-HP, Paris, France., Coriat R; Faculté de Médecine, Université Paris Cité, Paris, France.; Department of Gastroenterology, Hopital Cochin, AP-HP, Paris, France., Hoeffel C; Department of Radiology, Hopital Robert Debré, CHU Reims, Reims Medical School, University of Champagne Ardennes, Reims, France., Marchese U; Faculté de Médecine, Université Paris Cité, Paris, France.; Department of Digestive, Hepatobiliary and Endocrine Surgery, Hopital Cochin, AP-HP, Paris, France., Soyer P; Department of Radiology, Hopital Cochin, AP-HP, Paris, France.; Faculté de Médecine, Université Paris Cité, Paris, France.
Jazyk:	angličtina
Zdroj:	Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes [Can Assoc Radiol J] 2023 Aug; Vol. 74 (3), pp. 570-581. Date of Electronic Publication: 2022 Nov 08.
DOI:	10.1177/08465371221137885
Abstrakt:	Purpose: To assess interobserver variability and accuracy of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) in pancreatic ductal adenocarcinoma (PDAC) size estimation using surgical specimens as standard of reference. Methods: Patients with PDAC who underwent preoperative CT and MRI examinations before surgery were included. PDAC largest axial dimension was measured by 2 readers on 8 MRI sequence and 2 CT imaging phases (pancreatic parenchymal and portal venous). Measurements were compared to actual tumour size at pathologic examination. Interobserver variability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots. Differences in tumour size (Δdiameter) between imaging and actual tumour size were searched using Wilcoxon rank sum test. Results: Twenty-nine patients (16 men; median age, 70 years) with surgically resected PDAC were included. Interobserver reproducibility was good to excellent for all MRI sequences and the 2 CT imaging phases with ICCs between .862 (95%CI: .692-.942) for fat-saturated in-phase T1-weighted sequence and .955 (95%CI: .898-.980) for portal venous phase CT images. Best accuracy in PDAC size measurement was obtained with pancreatic parenchymal phase CT images with median Δdiameters of -2 mm for both readers, mean relative differences of -9% and -6% and no significant differences with dimensions at histopathological analysis ( P = .051). All MRI sequences led to significant underestimation of PDAC size (median Δdiameters, -6 to -1 mm; mean relative differences, -21% to -11%). Conclusions: Most accurate measurement of PDAC size is obtained with CT images obtained during the pancreatic parenchymal phase. MRI results in significant underestimation of PDAC size. Competing Interests: Declaration of Conflicting InterestsThe authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu