MRI-based Bosniak Classification of Cystic Renal Masses, Version 2019: Interobserver Agreement, Impact of Readers’ Experience, and Diagnostic Performance
| Autor: | Xu Bai, Peng Wu, Song-Mei Sun, Huiyi Ye, Ye-Qiang Jin, Si-Lu Chen, Xiaojing Zhang, Wei Xu, Qing-Rong Wang, Lin Li, Haiyi Wang, Huan-Huan Kang, Qingbo Huang, Hong-Yan Liu, Guo-Cheng Liang, Qing-Ge-Le Gong, Lin-Lin Liu, Aitao Guo |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Observer Variation business.industry Significant difference Diagnostic Specificity Mean age Kidney Diseases Cystic Middle Aged Magnetic Resonance Imaging 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine McNemar's test 030220 oncology & carcinogenesis Female patient Humans Medicine Female Radiology Nuclear Medicine and imaging Clinical Competence Clinical competence Nuclear medicine business Observer variation Retrospective Studies |
| Zdroj: | Radiology. 297:597-605 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2020200478 |
| Popis: | Background The 2019 Bosniak classification (version 2019) of cystic renal masses (CRMs) provides a systematic update to the currently used 2005 Bosniak classification (version 2005). Further validation is required before widespread application. Purpose To evaluate the interobserver agreement of MRI criteria, the impact of readers' experience, and the diagnostic performance between version 2019 and version 2005. Materials and Methods From January 2009 to December 2018, consecutive patients with CRM who had undergone renal MRI and surgical-pathologic examination were included in this retrospective study. On the basis of version 2019 and version 2005, all CRMs were independently classified by eight radiologists with different levels of experience. By using multirater κ statistics, interobserver agreement was evaluated with comparisons between classifications and between senior and junior radiologists. Diagnostic performance between classifications by dichotomizing classes I-IV into lower (I-IIF) and higher (III-IV) classes was compared by using the McNemar test. P < .05 was considered to indicate a statistically significant difference. Results A total of 207 patients (mean age ± standard deviation, 49 years ± 12; 139 male and 68 female patients) with CRMs were included. Overall, interobserver agreement was higher with version 2019 than version 2005 (weighted κ = 0.64 vs 0.50, respectively; P < .001). Interobserver agreement between senior and junior radiologists did not differ between version 2019 (weighted κ = 0.65 vs 0.64, respectively; P = .71) and version 2005 (weighted κ = 0.54 vs 0.46; P < .001). Diagnostic specificity for malignancy was higher with version 2019 than with version 2005 (83% [92 of 111] vs 68% [75 of 111], respectively; P < .001), without any difference in sensitivity (89% [85 of 96] vs 84% [81 of 96]; P = .34). Conclusion In the updated Bosniak classification, interobserver agreement improved and was unaffected by observers' experience. The diagnostic performance with version 2019 was superior to that with version 2005, with higher specificity. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Choyke in this issue. |
| Databáze: | OpenAIRE |
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