Background parenchymal enhancement assessment: Inter- and intra-rater reliability across breast MRI sequences
Background parenchymal enhancement assessment: Inter- and intra-rater reliability across breast MRI sequences
复制标题
DOI：
10.1016/j.ejrad.2019.02.036
复制
发表时间：
2019-05-01
影响因子：
3.3
通讯作者：
Mariscotti, Giovanna
中科院分区：
文献类型：
--
作者：
Bignotti, Bianca;Calabrese, Massimo;Mariscotti, Giovanna
目的：为了评估跨乳腺MRI sequences.Materials和方法的背景实质增强（BPE）评估的评估者间和内部的可靠性：获得机构审查委员会的批准和同意的要求被免除。三位放射科医师根据BI-RADS分类系统，使用四点量表（极轻微、轻度、中度或显著）对150例乳腺MRI上的BPE进行定性分类。根据用于评估BPE的MR序列，在具有四个选项的模拟阅读策略中进行了评估者间和评估者内可靠性评估：（1）初始对比度增强（CE）脂肪抑制的T1加权图像（2）初始CE减影图像（3）第一CE减影图像的最大强度投影（MIP）（4）初始CE脂肪抑制的T1加权的组合，初始CE减影和MIP图像。在初始评估后4周，评估者对45例乳腺MRI进行了重复BPE评估。采用Gwet's AC 1指数和序贯权重进行信度评价。Gwet的三位评分员之间的可靠性指数为0.68（0.63-0.74）使用初始对比增强脂肪抑制T1加权图像，0.74（0.69-0.80）使用减影图像，0.80（0.76-0.83）使用MIP，0.80（0.77-0.84）使用初始对比增强脂肪抑制T1加权，初始对比增强减影和MIP图像的组合。重测信度为0.81（0.60-1.00）对于评分者1，0.77（0.55-0.98）评分员2，0.79（0.59-0.99）对于等级3使用初始对比增强脂肪抑制T1加权、初始对比增强减影和MIP图像的组合。总体而言，所有CE MRI图像的组合显示了BPE评估的最高可靠性。然而，与所有CE MRI图像的组合相比，MIP显示出更低的阅读时间的高可靠性。
Objective: To evaluate inter- and intra-rater reliability of background parenchymal enhancement (BPE) assessment across breast MRI sequences.Materials and methods: Institutional review board approval was obtained and the requirement for consent was waived. Three radiologists qualitatively categorized BPE on 150 breast MRI using a four-point scale (minimal, mild, moderate or marked) according to BI-RADS category system. According to MR-sequence used for the assessment of BPE, inter-rater and intra-rater reliability across a simulated reading strategy with four options was performed: (1) initial contrast-enhanced (CE) fat-suppressed Tl-weighted images (2) initial CE subtracted images (3) maximum-intensity-projection (MIP) of the first CE subtracted images (4) combination of initial CE fat-suppressed Tl-weighted, initial CE subtracted and MIP images. Raters repeated BPE assessment of 45 breast MRI four weeks after the initial assessment. Gwet's AC1 index with ordinal weights was used to assess reliabilities.Results: Gwet's index for the reliability among the three raters was 0.68 (0.63-0.74) using initial contrast-enhanced fat-suppressed T1 weighted images, 0.74 (0.69-0.80) using subtracted images, 0.80 (0.76-0.83) using MIP, 0.80 (0.77-0.84) using a combination of the initial contrast-enhanced fat-suppressed T1 weighted, initial contrast-enhanced subtracted and MIP images. Test-retest reliability was 0.81 (0.60-1.00) for rater 1, 0.77 (0.55-0.98) for rater 2, 0.79 (0.59-0.99) for rater 3 using the combination of initial contrast-enhanced fat-suppressed T1 weighted, initial contrast-enhanced subtracted and MIP images.Conclusions: Overall, the combination of all CE MRI images showed the highest reliability of BPE assessment. However, MIP showed a high reliability with lower reading time compared to the combination of all CE MRI images.