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MRI interobserver reliability in rectal tumor angulation 直肠肿瘤角度的MRI观察者间可靠性
Pub Date : 2022-02-01 DOI: 10.1177/20584601221081292
M. Pedersen, P. Otto, H. Precht, S. Rafaelsen
Background When rectal tumors are examined using magnetic resonance imaging (MRI) the perpendicular angulation of the axial T2-weighted image to the tumor axis is essential for a correct measure of the shortest distance between tumor and mesorectal facia. Purpose The purpose of this study was to determine the interobserver variability in rectal tumor angulation between a radiologist and a radiographer. Material and Methods Two observers performed the angulation independently. All MRI examinations were performed using an MRI 1.5 Tesla unit. A Bland–Altman plot was used to assess the interobserver variance and Intraclass correlation coefficient (ICC) statistic was used to assess the interobserver reliability. Results MRI was performed in 55 patients with rectal cancer during a one-year period (25 (45.5%) women and 30 (54.5%) men). The median age was 71 years (range 46–87 years). The rectal tumor mean length was 3.9 cm. The interobserver reliability was good (ICC = 0.83, 95% confidence interval 0.72–0.90). Conclusion Radiographers receiving training will be able to perform MRI rectal tumor angulation.
背景:当使用磁共振成像(MRI)检查直肠肿瘤时,轴向t2加权图像与肿瘤轴的垂直角度对于正确测量肿瘤与肠系膜表面之间的最短距离至关重要。目的本研究的目的是确定在放射科医生和放射技师之间观察直肠肿瘤成角的变异性。材料与方法两名观察员独立进行成角。所有MRI检查均使用MRI 1.5特斯拉设备进行。采用Bland-Altman图评估观察者间方差,采用class内相关系数(ICC)统计量评估观察者间信度。结果55例直肠癌患者1年内行MRI检查,其中女性25例(45.5%),男性30例(54.5%)。中位年龄为71岁(46-87岁)。直肠肿瘤平均长度为3.9 cm。观察者间信度良好(ICC = 0.83, 95%置信区间0.72-0.90)。结论经过培训的放射技师能够进行MRI直肠肿瘤成角检查。
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引用次数: 3
1H-MR spectroscopy in grading of cerebral glioma: A new view point, MRS image quality assessment 磁共振成像在脑胶质瘤分级中的应用:磁共振成像质量评价的新视角
Pub Date : 2022-02-01 DOI: 10.1177/20584601221077068
Tahir M Shakir, Liang Fengli, Guo Chenguang, N. Chen, Ming Zhang, Mai Shaohui
Background Noninvasive preoperative prediction of histological grading is essential for clinical management of cerebral glioma. Purpose This study aimed to investigate the association between the image quality assessment of 1H magnetic resonance spectroscopy and accurate grading of glioma. Materials and Methods 98 glioma patients confirmed by pathology were retrospectively recruited in this single-center study. All patients underwent 1H-MRS examination at 3.0T before surgery. According to WHO standards, all cases were divided into two groups: low-grade glioma (grade I and II, 48 cases) and high-grade glioma (grades III and IV, 50 cases). The metabolite ratios in both grades were calculated before and after image quality assessment. The area under the receiver operating characteristic (ROC) curve was used to evaluate the capacity of each ratio in glioma grading. Results The Cho/Cr, Cho/NAA and NAA/Cr metabolite ratios had certain differences in each glioma group before and after MRS image quality assessment. In the low-grade glioma group, there was a dramatic difference in the Cho/Cr ratio before and after image quality assessment (p = 0.011). After MRS image quality assessment, the accuracy of glioma grading was significantly improved. The Cho/Cr ratio with 83.3% sensitivity and 93.7% specificity is the best index of glioma grading, with the optimal cutoff value of the Cho/Cr ratio being 3.72. Conclusion The image quality of MRS does affect the metabolite ratios and the results of glioma grading. MRS image quality assessment can observably improve the accuracy rate of glioma grading. The Cho/Cr ratio has the best diagnostic performance in differentiating high-grade from low-grade glioma.
背景无创的术前组织学分级预测对脑胶质瘤的临床治疗至关重要。目的本研究旨在探讨1H核磁共振波谱图像质量评估与胶质瘤准确分级之间的关系。材料与方法对98例经病理证实的胶质瘤患者进行回顾性研究。所有患者在术前3.0T进行1H-MRS检查。根据世界卫生组织标准,将所有病例分为两组:低级别神经胶质瘤(Ⅰ、Ⅱ级,48例)和高级别神经胶质癌(Ⅲ、Ⅳ级,50例)。在图像质量评估前后计算两个级别的代谢物比率。受试者工作特性(ROC)曲线下面积用于评估神经胶质瘤分级中每个比率的能力。结果MRS图像质量评价前后各组脑胶质瘤的Cho/Cr、Cho/NAA和NAA/Cr代谢产物比值存在一定差异。在低级别胶质瘤组中,图像质量评估前后的Cho/Cr比率有显著差异(p=0.011)。MRS图像质量评估后,胶质瘤分级的准确性显著提高。Cho/Cr比值灵敏度为83.3%,特异性为93.7%,是胶质瘤分级的最佳指标,Cho/Cr比的最佳截断值为3.72。结论MRS的图像质量影响代谢产物的比例和胶质瘤分级结果。MRS图像质量评估可以显著提高胶质瘤分级的准确率。Cho/Cr比值在区分高级别和低级别胶质瘤方面具有最佳的诊断性能。
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引用次数: 3
Subclinical involvement of the trunk muscles in idiopathic inflammatory myopathies 特发性炎性肌病中躯干肌肉的亚临床累及
Pub Date : 2022-02-01 DOI: 10.1177/20584601221075796
N. Matsuda, Shunsuke Kobayashi, O. Hasegawa, K. Yoshida, H. Kubo, Y. Ugawa, K. Kanai
Background Whole-body magnetic resonance imaging (WB-MRI) is a useful tool for revealing the disease-specific distribution of affected muscles and clinically asymptomatic muscle involvements in idiopathic inflammatory myopathies (IIMs). Purpose To examine inflammatory changes in the systemic skeletal muscles, including the thoracoabdominal trunk, in IIMs using WB-MRI. Material and Methods We prospectively obtained WB-MRI axial images from 10 patients with IIMs, including antisynthetase syndrome (ASS), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis, and myopathy associated with antimitochondrial antibody. We evaluated 108 systemic skeletal muscles in short-tau inversion recovery (STIR) images and rated changes in signal intensity using a semiquantitative scale. Correlations between STIR sum score, peak creatine kinase (CK) and muscle strength were examined. We also investigated the correlation between STIR sum score within the thoracoabdominal trunk and forced vital capacity. Results High STIR signal changes were frequently identified in asymptomatic and routinely unexamined muscles. Thoracoabdominal trunk muscles were frequently involved in ASS and IMNM. Peak CK was positively correlated with the STIR sum score (R2 = 0.62, p < .01). There was no significant correlation between the STIR sum score within the thoracoabdominal trunk and forced vital capacity. Conclusion WB-MRI can detect subclinical muscle inflammation in the systemic muscles including the trunk muscles. STIR sum score is positively correlated with serum peak CK level; therefore, it could be a biomarker of overall muscle inflammation.
背景:全身磁共振成像(WB-MRI)是揭示特发性炎症性肌病(IIMs)中受影响肌肉的疾病特异性分布和临床无症状肌肉受累的有用工具。目的应用WB-MRI检查IIMs患者全身骨骼肌(包括胸腹干)的炎症变化。材料与方法前瞻性获得10例IIMs患者的WB-MRI轴向图像,包括抗合成酶综合征(ASS)、免疫介导的坏死性肌病(IMNM)、散发性包涵体肌炎和抗线粒体抗体相关的肌病。我们在短tau反转恢复(STIR)图像中评估了108个全身骨骼肌,并使用半定量量表评估了信号强度的变化。检测STIR总分、肌酸激酶峰值(CK)与肌力的相关性。我们还研究了胸腹干STIR总分与强迫肺活量的相关性。结果在无症状和常规未检查的肌肉中经常发现高STIR信号改变。胸腹干肌常累及ASS和IMNM。CK峰值与STIR总分呈正相关(R2 = 0.62, p < 0.01)。胸腹干STIR总分与用力肺活量无显著相关性。结论WB-MRI可检测包括躯干肌肉在内的全身肌肉的亚临床肌肉炎症。STIR总分与血清CK峰值水平呈正相关;因此,它可能是整体肌肉炎症的生物标志物。
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引用次数: 2
Geographical variations in the use of outpatient diagnostic imaging in Norway 2019 2019年挪威门诊诊断成像使用的地理差异
Pub Date : 2022-02-01 DOI: 10.1177/20584601221074561
B. Hofmann, A. M. Gransjøen
Background Geographical variations in the use of outpatient imaging can reveal inappropriate use of radiological services. Knowledge about these variations is crucial in the strive for appropriate and improved services. Purpose To investigate the geographical variations in outpatient diagnostic imaging and analyze variations for main groups of examinations and for specific examinations. Material and methods Data on outpatient radiological procedures registered at the Norwegian Health Economics Administration in Norway for 2019 were accessed with county-based population rates for age adjustment accessed through Statistics Norway. Age-adjusted rates were used to calculate high/low ratios, means, standard deviations, and coefficients of variation were calculated per 10,000 inhabitants. Results There is high geographical variation for PET/CT and PET/MRI and moderate variation for neuroradiological outpatient examinations in Norway in 2019. Variations for the musculoskeletal systems and of thorax, abdomen, and vessels are almost 50%. We find high high-to-low ratios in CT—face (9.7), MRI—elbow joint (8.5), CT of the neck, thorax, abdomen, and pelvis (6.5) as well as MRI—prostate (6.2). Comparing with data from 2012–5, we find a reduction in variation for some examinations, such as MRI of the hip and MRI of the entire spine, and an increase in variations for others, such as CT of the face and MRI of the elbow joint. Conclusion Despite much attention to the problem, we demonstrate substantial variations in radiological services in Norway raising concern with respect to appropriateness, quality of care, equity, and justice. The findings provide important input for quality improvement in radiological services.
背景门诊影像使用的地理差异可以揭示放射服务的不当使用。了解这些变化对于争取适当和改进的服务至关重要。目的调查门诊诊断影像学的地理差异,分析主要检查组和特定检查的差异。材料和方法2019年在挪威卫生经济管理局登记的门诊放射学程序数据通过挪威统计局获取,并根据年龄调整的县人口率进行访问。年龄调整率用于计算每10000名居民的高/低比率、平均值、标准差和变异系数。结果2019年挪威PET/CT和PET/MRI的地理差异较大,神经放射学门诊检查的地理差异中等。肌肉骨骼系统、胸部、腹部和血管的变化几乎为50%。我们发现CT——面部(9.7)、MRI——肘关节(8.5)、颈部、胸部、腹部和骨盆的CT(6.5)以及MRI——前列腺(6.2)的高-低比率。与2012-2015年的数据相比,我们发现一些检查的变化减少,如髋关节的MRI和整个脊椎的MRI,而其他检查的变化增加,如面部的CT和肘关节的MRI。结论尽管人们非常关注这个问题,但我们发现挪威的放射服务存在很大差异,这引发了人们对适当性、护理质量、公平性和公正性的担忧。这些发现为提高放射服务的质量提供了重要的投入。
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引用次数: 4
Chest imaging in pregnant patients with COVID-19: Recommendations, justification, and optimization 妊娠COVID-19患者的胸部影像学:建议、理由和优化
Pub Date : 2022-02-01 DOI: 10.1177/20584601221077394
A. Nair, S. Ramanathan, P. Venugopalan
Evaluation of COVID-19 related complication is challenging in pregnancy, due to concerns about ionizing radiation risk to mother and the fetus. Although there are instances when diagnostic imaging is clinically warranted for COVID-19 evaluation despite the minimal risks of radiation exposure, often there are concerns raised by the patients and sometimes by the attending physicians. This article reviews the current recommendations on indications of chest imaging in pregnant patients with COVID-19, the dose optimization strategies, and the risks related to imaging exposure during pregnancy. In clinical practice, these imaging strategies are key in addressing the complex obstetrical complications associated with COVID-19 pneumonia.
由于担心电离辐射对母亲和胎儿的风险,新冠肺炎相关并发症的评估在妊娠期具有挑战性。尽管在某些情况下,尽管辐射暴露的风险很小,但诊断成像在临床上仍有必要用于新冠肺炎评估,但患者有时也会提出担忧。本文综述了目前关于新冠肺炎妊娠患者胸部影像学适应症、剂量优化策略和妊娠期影像学暴露相关风险的建议。在临床实践中,这些成像策略是解决与新冠肺炎肺炎相关的复杂产科并发症的关键。
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引用次数: 6
Advanced magnetic resonance imaging findings of cerebellar hemangioblastomas: A report of three cases and a literature review 小脑血管母细胞瘤的高级磁共振成像:3例报告和文献复习
Pub Date : 2022-02-01 DOI: 10.1177/20584601221077074
E. Matsusue, Chie Inoue, S. Tabuchi, H. Yoshioka, Yuichiro Nagao, Kensuke Matsumoto, Kazuhiko Nakamura, S. Fujii
On conventional magnetic resonance imaging (MRI), hemangioblastomas typically appear as mural nodules with an adjacent surrounding cyst or a solid mass in the cerebellum. However, hemangioblastomas sometimes cannot be reliably distinguished using this imaging technique from other tumors, especially pilocytic astrocytomas and metastatic tumors, because of their similar imaging findings and locations. Herein, we report three cases of cerebellar hemangioblastomas and review their findings on conventional and advanced MRI, including diffusion-weighted imaging (DWI), dynamic susceptibility-weighted contrast-enhanced perfusion-weighted imaging (DSC-PWI), and magnetic resonance spectroscopy (MRS). Solid contrast-enhanced lesions of hemangioblastomas showed increased apparent diffusion coefficient values on DWI, increased relative cerebral blood volume ratio on DSC-PWI, and high lipid/lactate peak on MRS. Therefore, advanced MRI techniques can be helpful in understanding the pathological and metabolic changes of hemangioblastomas and may be useful for their characterization.
在传统的磁共振成像(MRI)中,血管母细胞瘤通常表现为附壁结节,周围有囊肿或小脑中的实体瘤。然而,使用这种成像技术有时无法可靠地将血管母细胞瘤与其他肿瘤区分开来,尤其是毛细胞星形细胞瘤和转移性肿瘤,因为它们的成像结果和位置相似。在此,我们报告了三例小脑血管母细胞瘤,并回顾了他们在常规和高级MRI上的发现,包括弥散加权成像(DWI)、动态磁化率加权对比增强灌注加权成像(DSC-PWI)和磁共振波谱(MRS)。血管母细胞瘤的实体增强病变在DWI上显示出表观扩散系数值增加,在DSC-PWI上显示出相对脑血容量比增加,在MRS上显示出高脂质/乳酸峰。因此,先进的MRI技术有助于了解血管母细胞癌的病理和代谢变化,并可能有助于其表征。
{"title":"Advanced magnetic resonance imaging findings of cerebellar hemangioblastomas: A report of three cases and a literature review","authors":"E. Matsusue, Chie Inoue, S. Tabuchi, H. Yoshioka, Yuichiro Nagao, Kensuke Matsumoto, Kazuhiko Nakamura, S. Fujii","doi":"10.1177/20584601221077074","DOIUrl":"https://doi.org/10.1177/20584601221077074","url":null,"abstract":"On conventional magnetic resonance imaging (MRI), hemangioblastomas typically appear as mural nodules with an adjacent surrounding cyst or a solid mass in the cerebellum. However, hemangioblastomas sometimes cannot be reliably distinguished using this imaging technique from other tumors, especially pilocytic astrocytomas and metastatic tumors, because of their similar imaging findings and locations. Herein, we report three cases of cerebellar hemangioblastomas and review their findings on conventional and advanced MRI, including diffusion-weighted imaging (DWI), dynamic susceptibility-weighted contrast-enhanced perfusion-weighted imaging (DSC-PWI), and magnetic resonance spectroscopy (MRS). Solid contrast-enhanced lesions of hemangioblastomas showed increased apparent diffusion coefficient values on DWI, increased relative cerebral blood volume ratio on DSC-PWI, and high lipid/lactate peak on MRS. Therefore, advanced MRI techniques can be helpful in understanding the pathological and metabolic changes of hemangioblastomas and may be useful for their characterization.","PeriodicalId":72063,"journal":{"name":"Acta radiologica open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47537717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Breast cancer detection across dense and non-dense breasts: Markers of diagnostic confidence and efficacy. 乳腺癌在致密和非致密乳房的检测:诊断信心和疗效的标志。
Pub Date : 2022-01-29 eCollection Date: 2022-01-01 DOI: 10.1177/20584601211072279
Ibrahim Hadadi, William Rae, Jillian Clarke, Mark McEntee, Ernest Ekpo

Background: The impact of radiologists' characteristics has become a major focus of recent research. However, the markers of diagnostic efficacy and confidence in dense and non-dense breasts are poorly understood.

Purpose: This study aims to assess the relationship between radiologists' characteristics and diagnostic performance across dense and non-dense breasts.

Materials and methods: Radiologists specialising in breast imaging (n = 128) who had 0.5-40 (13±10.6) years of experience reading mammograms were recruited. Participants independently interpreted a test set containing 60 digital mammograms (40 normal and 20 abnormal) with similarly distributed breast densities. Diagnostic performance measures were analysed via Jamovi software (version 1.6.22).

Results: In dense breasts, breast-imaging fellowship completion significantly improved specificity (p = 0.004), location sensitivity (p = 0.01) and the area under the curve (AUC) of the receiver operating characteristic (p = 0.03). Only participation in BreastScreen reading significantly improved all performance metrics: specificity (p = 0.04), sensitivity (p = 0.005), location sensitivity (p < 0.001) and AUC (p < 0.001). Reading > 100 mammograms weekly significantly improved sensitivity (p = 0.03), location sensitivity (p = 0.001), and AUC (p = 0.03).In non-dense breasts, breast fellowship completion significantly improved sensitivity (p = 0.02), location sensitivity (p = 0.04) and AUC (p = 0.002). Participation in BreastScreen reading and reading > 100 mammograms weekly significantly improved only sensitivity (p = 0.002 and p = 0.003, respectively) and location sensitivity (p < 0.001 and p < 0.001, respectively).

Conclusion: Participating in screening programs, breast fellowships and reading > 100 mammograms weekly are important indicators of the diagnostic performance of radiologists across dense and non-dense breasts. In dense breasts, optimal performance resulted from participation in a breast screening program.

背景:放射科医生特征的影响已成为近期研究的主要焦点。然而,对致密性和非致密性乳房的诊断效能和信心的标志物了解甚少。目的:本研究的目的是评估放射科医生的特点和诊断性能之间的关系在致密和非致密乳房。材料与方法:招募具有0.5 ~ 40(13±10.6)年乳房x光片阅读经验的乳腺影像学专家128名。参与者独立解释了包含60张乳腺密度分布相似的数字乳房x光片(40张正常,20张异常)的测试集。通过Jamovi软件(版本1.6.22)分析诊断性能指标。结果:在致密乳腺中,完成乳腺影像学检查可显著提高特异性(p = 0.004)、定位敏感性(p = 0.01)和受者工作特征曲线下面积(AUC) (p = 0.03)。仅参与乳房筛查读数可显著改善所有性能指标:特异性(p = 0.04)、敏感性(p = 0.005)、位置敏感性(p < 0.001)和AUC (p < 0.001)。每周阅读> 100次乳房x光片可显著提高灵敏度(p = 0.03)、定位灵敏度(p = 0.001)和AUC (p = 0.03)。在非致密乳房中,乳房闭合可显著提高灵敏度(p = 0.02)、位置灵敏度(p = 0.04)和AUC (p = 0.002)。参与BreastScreen阅读和每周阅读> 100张乳房x线照片显著提高了灵敏度(分别为p = 0.002和p = 0.003)和定位灵敏度(分别为p < 0.001和p < 0.001)。结论:参与筛查项目、乳腺奖学金、每周阅读> 100张乳房x光片是衡量放射科医师对致密和非致密乳房诊断效能的重要指标。在致密性乳房中,最佳的表现源于参与乳房筛查项目。
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引用次数: 2
Non-contrast-enhanced magnetic resonance imaging can be used to assess renal cortical and medullary volumes-A validation study. 非对比增强磁共振成像可用于评估肾皮质和髓质体积-一项验证研究。
Pub Date : 2022-01-21 eCollection Date: 2022-01-01 DOI: 10.1177/20584601211072281
Jonas Liefke, Katarina Steding-Ehrenborg, Daniel Asgeirsson, David Nordlund, Sascha Kopic, Eva Morsing, Erik Hedström

Background: Magnetic resonance imaging (MRI) biomarkers can diagnose and prognosticate kidney disease. Renal volume validation studies are however scarce, and measurements are limited by use of contrast agent or advanced post-processing.

Purpose: To validate a widely available non-contrast-enhanced MRI method for quantification of renal cortical and medullary volumes in pigs; investigate observer variability of cortical and medullary volumes in humans; and present reference values for renal cortical and medullary volumes in adolescents.

Materials and methods: Cortical and medullary volumes were quantified from transaxial in-vivo water-excited MR images in six pigs and 15 healthy adolescents (13-16years). Pig kidneys were excised, and renal cortex and medulla were separately quantified by the water displacement method. Both limits of agreement by the Bland-Altman method and reference ranges are presented as 2.5-97.5 percentiles.

Results: Agreement between MRI and ex-vivo quantification were -7 mL (-10-0 mL) for total parenchyma, -4 mL (-9-3 mL) for cortex, and -2 mL (-7-2 mL) for medulla. Intraobserver variability for pig and human kidneys were <5% for total parenchyma, cortex, and medulla. Interobserver variability for both pig and human kidneys were ≤4% for total parenchyma and cortex, and 6% and 12% for medulla. Reference ranges indexed for body surface area and sex were 54-103 mL/m2 (boys) and 56-103 mL/m2 (girls) for total parenchyma, 39-62 mL/m2 and 36-68 mL/m2 for cortex, and 16-45 mL/m2 and 17-42 mL/m2 for medulla.

Conclusion: The proposed widely available non-contrast-enhanced MRI method can quantify cortical and medullary renal volumes and can be directly implemented clinically.

背景:磁共振成像(MRI)生物标志物可以诊断和预测肾脏疾病。然而,肾容量验证研究很少,测量受到使用造影剂或先进后处理的限制。目的:验证一种广泛使用的非对比增强MRI定量猪肾皮质和肾髓体积的方法;研究人类皮层和髓质体积的观察变异性;并提出了青少年肾皮质和肾髓体积的参考值。材料和方法:对6头猪和15名健康青少年(13-16岁)的体内经轴水激磁共振成像进行皮质和髓质体积量化。取猪肾,分别用水置换法定量肾皮质和肾髓质。Bland-Altman方法的一致性界限和参考范围均为2.5-97.5个百分点。结果:MRI与离体定量的一致性为:全实质-7 mL (-10-0 mL),皮层-4 mL (-9-3 mL),髓质-2 mL (-7-2 mL)。猪和人肾脏的观察内变异性为:总实质为2 mL/m2(男孩)和56-103 mL/m2(女孩),皮质为39-62 mL/m2和36-68 mL/m2,髓质为16-45 mL/m2和17-42 mL/m2。结论:本文提出的非对比增强MRI方法可量化肾皮质和肾髓质体积,可直接应用于临床。
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引用次数: 1
Early detection of recurrent lung cancer: Enhancing-nodule in post-radiation fibrosis. 肺癌复发的早期发现:放疗后纤维化的增强结节。
Pub Date : 2022-01-21 eCollection Date: 2022-01-01 DOI: 10.1177/20584601211072280
Rituparna Saha, David Ryan, Emer Hanrahan, Jonathan D Dodd

Early detection of lung cancer recurrence on imaging is critical for better clinical prognosis. The 'enhancing nodule in post-radiation fibrosis sign' is an important sign which helps detect recurrent lung cancer early on CT chest.

早期影像学发现肺癌复发对改善临床预后至关重要。放射后增强结节纤维化征象是胸部CT早期发现肺癌复发的重要征象。
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引用次数: 1
Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients? 亚毫西弗胸部CT方案会影响疑似COVID-19患者的诊断质量吗?
Pub Date : 2022-01-19 eCollection Date: 2022-01-01 DOI: 10.1177/20584601211073864
Hans-Martin Thieß, Keno K Bressem, Lisa Adams, Georg Böning, Janis L Vahldiek, Stefan M Niehues

Background: During the ongoing global SARS-CoV-2 pandemic, there is a high demand for quick and reliable methods for early identification of infected patients. Due to its widespread availability, chest-CT is commonly used to detect early pulmonary manifestations and for follow-ups.

Purpose: This study aims to analyze image quality and reproducibility of readings of scans using low-dose chest CT protocols in patients suspected of SARS-CoV-2 infection.

Materials and methods: Two radiologists retrospectively analyzed 100 low-dose chest CT scans of patients suspected of SARS-CoV-2 infection using two protocols on devices from two vendors regarding image quality based on a Likert scale. After 3 weeks, quality ratings were repeated to allow for analysis of intra-reader in addition to the inter-reader agreement. Furthermore, radiation dose and presence as well as distribution of radiological features were noted.

Results: The exams' effective radiation doses were in median in the submillisievert range (median of 0.53 mSv, IQR: 0.35 mSv). While most scans were rated as being of optimal quality, 38% of scans were scored as suboptimal, yet only one scan was non-diagnostic. Inter-reader and intra-reader reliability showed almost perfect agreement with Cohen's kappa of 0.82 and 0.87.

Conclusion: Overall, in this study, we present two protocols for submillisievert low-dose chest CT demonstrating appropriate or better image quality with almost perfect inter-reader and intra-reader agreement in patients suspected of SARS-CoV-2 infection.

背景:在持续的全球SARS-CoV-2大流行期间,对快速可靠的早期识别感染患者的方法有很高的需求。由于其广泛使用,胸部ct通常用于检测早期肺部表现和随访。目的:本研究旨在分析疑似SARS-CoV-2感染患者使用低剂量胸部CT方案扫描的图像质量和读数的可重复性。材料和方法:两名放射科医生回顾性分析了100例疑似SARS-CoV-2感染患者的低剂量胸部CT扫描,使用两种方案,来自两家供应商的设备,基于李克特量表的图像质量。3周后,重复质量评分,以便分析读卡器内部和读卡器之间的一致性。此外,还记录了辐射剂量和存在以及放射特征的分布。结果:体检者的有效辐射剂量处于亚毫西弗范围的中位数(中位数为0.53 mSv, IQR为0.35 mSv)。虽然大多数扫描被评为最佳质量,但38%的扫描被评为次优,但只有一次扫描是非诊断性的。读者间和读者内信度与Cohen的kappa(0.82和0.87)几乎完全一致。结论:总体而言,在本研究中,我们提出了两种亚毫西弗低剂量胸部CT方案,在疑似SARS-CoV-2感染的患者中显示出适当或更好的图像质量,读取器间和读取器内几乎完全一致。
{"title":"Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?","authors":"Hans-Martin Thieß,&nbsp;Keno K Bressem,&nbsp;Lisa Adams,&nbsp;Georg Böning,&nbsp;Janis L Vahldiek,&nbsp;Stefan M Niehues","doi":"10.1177/20584601211073864","DOIUrl":"https://doi.org/10.1177/20584601211073864","url":null,"abstract":"<p><strong>Background: </strong>During the ongoing global SARS-CoV-2 pandemic, there is a high demand for quick and reliable methods for early identification of infected patients. Due to its widespread availability, chest-CT is commonly used to detect early pulmonary manifestations and for follow-ups.</p><p><strong>Purpose: </strong>This study aims to analyze image quality and reproducibility of readings of scans using low-dose chest CT protocols in patients suspected of SARS-CoV-2 infection.</p><p><strong>Materials and methods: </strong>Two radiologists retrospectively analyzed 100 low-dose chest CT scans of patients suspected of SARS-CoV-2 infection using two protocols on devices from two vendors regarding image quality based on a Likert scale. After 3 weeks, quality ratings were repeated to allow for analysis of intra-reader in addition to the inter-reader agreement. Furthermore, radiation dose and presence as well as distribution of radiological features were noted.</p><p><strong>Results: </strong>The exams' effective radiation doses were in median in the submillisievert range (median of 0.53 mSv, IQR: 0.35 mSv). While most scans were rated as being of optimal quality, 38% of scans were scored as suboptimal, yet only one scan was non-diagnostic. Inter-reader and intra-reader reliability showed almost perfect agreement with Cohen's kappa of 0.82 and 0.87.</p><p><strong>Conclusion: </strong>Overall, in this study, we present two protocols for submillisievert low-dose chest CT demonstrating appropriate or better image quality with almost perfect inter-reader and intra-reader agreement in patients suspected of SARS-CoV-2 infection.</p>","PeriodicalId":72063,"journal":{"name":"Acta radiologica open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8796096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39749912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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Acta radiologica open
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