Validation of the updated Bosniak classification (2019) in pathologically confirmed CT-categorised cysts.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Scottish Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-12-18 DOI:10.1177/00369330231221235
James Lucocq, Leo Morgan, Ketan Rathod, Magdalena Szewczyk-Bieda, Ghulam Nabi
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Abstract

Introduction: The updated Bosniak classification in 2019 (v2019) addresses vague imaging terms and revises the criteria with the intent to categorise a higher proportion of cysts in lower-risk groups and reduce benign cyst resections. The aim of the present study was to compare the diagnostic accuracy and inter-observer agreement rate of the original (v2005) and updated classifications (v2019).

Method: Resected/biopsied cysts were categorised according to Bosniak classifications (v2005 and v2019) and the diagnostic accuracy was assessed with reference to histopathological analysis. The inter-observer agreement of v2005 and v2019 was determined.

Results: The malignancy rate of the cohort was 83.6% (51/61). Using v2019, a higher proportion of malignant cysts were categorised as Bosniak ≥ III (88.2% vs 84.3%) and a significantly higher percentage were categorised as Bosniak IV (68.9% vs 47.1%; p = 0.049) in comparison to v2005. v2019 would have resulted in less benign cyst resections (13.5% vs 15.7%). Calcified versus non-calcified cysts had lower rates of malignancy (57.1% vs 91.5%; RR,0.62; p = 0.002). The inter-observer agreement of v2005 was higher than that of v2019 (kappa, 0.70 vs kappa, 0.43).

Discussion: The updated classification improves the categorisation of malignant cysts and reduces benign cyst resection. The low inter-observer agreement remains a challenge to the updated classification system.

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在病理确诊的 CT 分类囊肿中验证更新的 Bosniak 分类(2019)。
导言:2019 年更新的 Bosniak 分类(v2019)解决了成像术语模糊的问题,并修订了标准,旨在将更高比例的囊肿归入低风险组,减少良性囊肿切除。本研究旨在比较原始分类标准(v2005)和更新后的分类标准(v2019)的诊断准确性和观察者之间的一致率:根据波什尼亚克分类法(v2005 和 v2019)对切除/活检的囊肿进行分类,并参照组织病理学分析评估诊断准确性。结果表明,v2005 和 v2019 的观察者间一致性良好:结果:队列中的恶性肿瘤率为83.6%(51/61)。使用 v2019,与 v2005 相比,恶性囊肿被归类为 Bosniak ≥ III 的比例更高(88.2% vs 84.3%),被归类为 Bosniak IV 的比例明显更高(68.9% vs 47.1%;p = 0.049)。钙化与非钙化囊肿的恶性率较低(57.1% vs 91.5%;RR,0.62;p = 0.002)。v2005的观察者间一致性高于v2019(kappa, 0.70 vs kappa, 0.43):讨论:更新后的分类改进了恶性囊肿的分类,减少了良性囊肿的切除。观察者之间的一致性较低仍是更新版分类系统面临的挑战。
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来源期刊
Scottish Medical Journal
Scottish Medical Journal 医学-医学:内科
CiteScore
4.80
自引率
3.70%
发文量
42
审稿时长
>12 weeks
期刊介绍: A unique international information source for the latest news and issues concerning the Scottish medical community. Contributions are drawn from Scotland and its medical institutions, through an array of international authors. In addition to original papers, Scottish Medical Journal publishes commissioned educational review articles, case reports, historical articles, and sponsoring society abstracts.This journal is a member of the Committee on Publications Ethics (COPE).
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