Bosniak classification version 2019: a prospective comparison of CT and MRI
Bosniak classification version 2019: a prospective comparison of CT and MRI
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DOI：
10.1007/s00330-022-09044-3
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发表时间：
2022-08-13
影响因子：
5.9
通讯作者：
Metwally, Maha Ibrahim
中科院分区：
文献类型：
--
作者：
Almalki, Yassir Edrees;Basha, Mohammad Abd Alkhalik;Metwally, Maha Ibrahim
目的以2019年Bosniak分类标准(BCv2019)为标准，评价CT和MRI的诊断准确性和一致性。材料与方法前瞻性多机构研究纳入63例患者，超声检查发现67个囊性肾肿块(CRM)。所有患者均行CT、MRI扫描及组织病理学检查。三位放射科医生使用BCv2019独立评估了CRM，并使用CT和MRI为每个CRM分配了Bosniak级。最终分析包括60例经组织病理证实的CRM(41例恶性，19例良性)。结果按Bosniak分类分析，50%(30/60)的CRM的CT和MRI表现不一致。其中恶性16例(53.3%)。BCv2019与CT诊断BCv2019的敏感性、特异性和准确性无差异(87.8%；95%CI=73.8~95.9%比75.6%；95%CI=59.7~87.6%；p=0.09，84.2%；95%CI=60.4~96.6%比78.9%；95%CI=54.4~93.9%；p=0.5，86.7%；95%CI=64.0-86.6%对76.7%；95%CI=75.4-94.1%；P=0.1)。间隔的数目和厚度以及强化结节的存在是CT和MRI之间Bosniak分级差异的主要原因。读者间一致性(IRA)对CT和MRI的Bosniak分级有重要意义(k=0.66；95%CI=0.54~0.76，k=0.62；95%CI=0.50~0.73)。BCv219在CT和MRI间的一致性为中等(kappa=0.58)。结论根据BCv2019标准，CT和MRI在CRM的分类上具有可比性，在诊断准确性和可靠性方面无显著差异。
Objective To assess the diagnostic accuracy and agreement of CT and MRI in terms of the Bosniak classification version 2019 (BCv2019). Materials and methods A prospective multi-institutional study enrolled 63 patients with 67 complicated cystic renal masses (CRMs) discovered during ultrasound examination. All patients underwent CT and MRI scans and histopathology. Three radiologists independently assessed CRMs using BCv2019 and assigned Bosniak class to each CRM using CT and MRI. The final analysis included 60 histopathologically confirmed CRMs (41 were malignant and 19 were benign). Results Discordance between CT and MRI findings was noticed in 50% (30/60) CRMs when data were analyzed in terms of the Bosniak classes. Of these, 16 (53.3%) were malignant. Based on consensus reviewing, there was no difference in the sensitivity, specificity, and accuracy of the BCv2019 with MRI and BCv2019 with CT (87.8%; 95% CI = 73.8-95.9% versus 75.6%; 95% CI = 59.7-87.6%; p = 0.09, 84.2%; 95% CI = 60.4-96.6% versus 78.9%; 95% CI = 54.4-93.9%; p = 0.5, and 86.7%; 95% CI = 64.0-86.6% versus 76.7%; 95% CI = 75.4-94.1%; p = 0.1, respectively). The number and thickness of septa and the presence of enhanced nodules accounted for the majority of variations in Bosniak classes between CT and MRI. The inter-reader agreement (IRA) was substantial for determining the Bosniak class in CT and MRI (k = 0.66; 95% CI = 0.54-0.76, k = 0.62; 95% CI = 0.50-0.73, respectively). The inter-modality agreement of the BCv219 between CT and MRI was moderate (kappa = 0.58). Conclusion In terms of BCv2019, CT and MRI are comparable in the classification of CRMs with no significant difference in diagnostic accuracy and reliability.