Inter-observer variation and diagnostic efficacy of apparent diffusion coefficient (ADC) measurements obtained by diffusion-weighted imaging (DWI) in small renal masses
| Autor: | Domagoj Javor, Lothar Ponhold, Pascal A. T. Baltzer, Sabina Sevcenco, Gertraud Heinz-Peer, Martin Hofstetter |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Observer (quantum physics) Intraclass correlation Contrast Media 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Carcinoma medicine Humans Effective diffusion coefficient Radiology Nuclear Medicine and imaging Bland–Altman plot Aged Aged 80 and over Observer Variation Reproducibility Radiological and Ultrasound Technology business.industry Reproducibility of Results General Medicine Middle Aged medicine.disease Kidney Neoplasms Diffusion Magnetic Resonance Imaging 030220 oncology & carcinogenesis Female Nuclear medicine business Observer variation Diffusion MRI |
| Zdroj: | Acta Radiologica. 57:1014-1020 |
| ISSN: | 1600-0455 0284-1851 |
| DOI: | 10.1177/0284185115610934 |
| Popis: | Background Diffusion-weighted imaging (DWI) is increasingly used to diagnose renal lesion subtypes. Especially in small renal masses, identification of less aggressive tumor types is of clinical interest, as active surveillance strategies can be applied. Purpose To evaluate the inter-observer variation and diagnostic efficacy of apparent diffusion coefficient (ADC) measurements obtained by DWI in small renal masses ≤4 cm (SRM). Material and Methods This retrospective IRB-approved study included 39 patients (46 SRM: 12 benign, 34 malignant). All underwent a 3 T DWI of SRM prior to surgery. Two radiologists independently analyzed all imaging data by three measurements. Limits of agreement, intraclass correlation coefficients (ICC), group comparisons by t-tests, and ROC analysis were performed. Results Reliability of ADC measurements was very high with an ICC of >0.9 for both observers. Inter-rater reliability was high with an ICC of 0.82. Limits of agreement for average ADC values between both observers were −23.5% to 38.3% with a mean difference of 7.5% between both observers. No significant differences were found between benign and malignant lesions ( P value Observer 1: 0.362, Observer 2: 0.622). Papillary carcinoma showed lower ADC values compared to non-papillary carcinoma ( P value Observer 1: 0.008, Observer 2: 0.012). Consequently, ROC analysis revealed a significant ( P Conclusion ADC measurements of SRM at 3 T show a high reproducibility and differentiate papillary from non-papillary carcinoma subtypes. However, measurement variability may limit the application of fixed ADC thresholds for lesion diagnosis. |
| Databáze: | OpenAIRE |
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