MRI evaluation of extramural vascular invasion by inexperienced radiologists

Wang, Shuai; Li, Xiaoting; Zhang, Xiaoyan; Sun, Ruoyan; Qu, Yu-Hong; Zhu, Huici; Guan, Zhen; Sun, Ying‐Shi

doi:10.1259/bjr.20181055

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…A study examining the accuracy of screening mammogram interpretation found that radiologists who followed up cases in which they recommended further workup had higher specificity, while the interpretation of a higher volume of mammograms was not associated with better performance [28] . Similarly, diagnosis of extramural venous invasion in rectal cancer improved significantly following targeted training which included histological correlation, while there was no improvement in diagnostic accuracy for radiologists who performed clinical work without the targeted training [29] .…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Prostate Magnetic Resonance Imaging: Reader Experience Matters

Kang

Bamashmos

et al. 2021

European Urology Open Science

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Background Prostate magnetic resonance imaging (MRI) is increasingly used in the detection, image-guided biopsy, and active surveillance of prostate cancer. The accuracy of prostate MRI may differ based on factors including imaging technique, patient population, and reader experience. Objective To determine whether the accuracy of prostate MRI varies with reader experience. Design, setting, and participants We rescored regions of interest from 194 consecutive patients who had undergone MRI/ultrasonography fusion biopsy. Original prostate MRI scans had been interpreted by one of 33 abdominal radiologists (AR group). More than 14 mo later, rescoring was performed by two blinded, prostate MRI radiologists (PR group). Likert scoring was used for both original MRI reports and rescoring. Outcome measurements and statistical analysis Test performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of prostate MRI was defined for the AR and PR groups. A Likert score of 4–5 was considered test positive and clinically significant prostate carcinoma (csPCa; Gleason grade group [GGG] ≥2) was considered outcome positive. Results and limitations MRI-positive lesions (Likert 4–5) scored by the PR group resulted in csPCa more frequently than those scored by the AR group (64.9% vs 39.3%). MRI-negative lesions (Likert 2–3) were more likely to result in a clinically insignificant biopsy (benign pathology or GGG 1) when scored by the PR versus the AR group (91.8% vs 76.6%). Sensitivity and specificity of MRI to detect csPCa were higher for the PR group than for the AR group (sensitivity 85.9% vs 70.7%; specificity 77.3% vs 46.8%). Overall diagnostic accuracy was higher for the PR group than for the AR group (80.1% vs 54.6%). Conclusions Sensitivity, specificity, PPV, and NPV of prostate MRI were higher for the PR group than for the AR group. Patient summary We examined the accuracy of prostate magnetic resonance imaging (MRI) in two groups of radiologists. Experienced radiologists were more likely to detect clinically significant prostate cancer on MRI.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Prostate Magnetic Resonance Imaging: Reader Experience Matters

Kang

Bamashmos

et al. 2021

European Urology Open Science

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“…MREMVI is a promising prognostic factor in rectal cancer, but can be difficult to assess. Two of the four inexperienced radiologists in a study by Wang et al received targeted training resulting in a 20% increase in agreement with expert reference [18]. A computer‐based self‐training module also showed improvement in lesion sensitivity on CT colonography from 74% to 83% ( p < 0.001) [22].…”

Section: Discussionmentioning

confidence: 99%

“…The training improved the overall agreement with the expert reference (53% before and 70% after the training). Radiological training for a higher agreement with the expert reference has previously been described to be of added value for the detection of extramural venous invasion on MRI (MREMVI) and the assessment of CT colonography [18][19][20][21]. MREMVI is a promising prognostic factor in rectal cancer, but can be difficult to assess.…”

Section: F I G U R Ementioning

confidence: 99%

Evaluation of the implementation of the sigmoid take‐off landmark in the Netherlands

et al. 2021

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Aim:The sigmoid take-off (STO), the point on imaging where the sigmoid sweeps ventral from the sacrum, was chosen as the definition of the rectum during an international Delphi consensus meeting and has been incorporated into the Dutch guidelines since October 2019. The aim of this study was to evaluate the implementation of this landmark 1 year after the guideline implementation and to perform a quality assessment of the STO training.Method: Dutch radiologists, surgeons, surgical residents, interns, PhD students and physician assistants were asked to complete a survey and classify 20 tumours on MRI as 'below', 'on' or 'above' the STO. Outcomes were agreement with the expert reference, inter-rater variability and accuracy before and after the training.Results: Eighty-six collaborators participated. Six radiologists (32%) and 11 surgeons (73%) used the STO as the standard landmark to distinguish between rectal and sigmoidal tumours during multidisciplinary meetings. Overall agreement with the expert reference improved from 53% to 70% (p < 0.001) after the training. The positive predictive value for diagnosing rectal tumours was high before and after the training (92% vs. 90%); the negative predictive value for diagnosing sigmoidal tumours improved from 39% to 63%. Conclusion: Approximately half of the represented hospitals have implemented the new definition of rectal cancer 1 year after the implementation of the Dutch national guidelines. Overall baseline agreement with the expert reference and accuracy for the tumours around the STO was low, but improved significantly after training. These results highlight the added value of training in implementation of radiological landmarks to ensure unambiguous assessment.

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“…All the patients underwent total mesorectal excision, which was confirmed by pathology after operation. According to the definition of EMVI in pathology ( 8 ), the positive criteria for EMVI were as follows: tumor cells were observed by HE staining to encase and invade the adipose tissue around the intestinal wall or the vascular wall under the serous membrane, or tumor cells invaded the vascular lumen outside the intestinal wall to form tumor cell emboli.…”

Section: Methodsmentioning

confidence: 99%

The Value of Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging Combined With Texture Analysis of Evaluating the Extramural Vascular Invasion in Rectal Adenocarcinoma

et al. 2022

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PurposeThis study aims to evaluate the value of 3.0T MRI Intravoxel Incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI) combined with texture analysis (TA) for evaluating extramural vascular invasion (EMVI) of rectal adenocarcinoma.MethodsNinety-six patients with pathologically confirmed rectal adenocarcinoma after surgical resections were collected. Patients were divided into the EMVI positive group (n=39) and the EMVI negative group (n=57). We measured the IVIM-DWI parameters and TA parameters of rectal adenocarcinoma. We compare the differences of the above parameters between the two groups and establish a prediction model through multivariate logistic regression analysis. the ROC curve was performed for parameters with each individual and in combination.ResultsADC, D, D* value between the two groups were statistically significant (P= 0.015,0.031,0). Six groups of texture parameters were statistically significant between the two groups (P=0.007,0.037,0.011,0.005,0.007,0.002). Logistic regression prediction model shows that GLCM entropy_ALL DIRECTION_offset7_SD and D* are important independent predictors, and the AUC of the regression prediction model was 0.821, the sensitivity was 92.98%, the specificity was 61.54%, and the Yoden index was 0.5452. The AUC was significantly higher than that of other single parameters.Conclusion3.0T MRI IVIM-DWI parameters combined with texture analysis can provide valuable information for EMVI evaluation of rectal adenocarcinoma before the operation.

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MRI evaluation of extramural vascular invasion by inexperienced radiologists

Cited by 10 publications

References 25 publications

Accuracy of Prostate Magnetic Resonance Imaging: Reader Experience Matters

Accuracy of Prostate Magnetic Resonance Imaging: Reader Experience Matters

Evaluation of the implementation of the sigmoid take‐off landmark in the Netherlands

The Value of Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging Combined With Texture Analysis of Evaluating the Extramural Vascular Invasion in Rectal Adenocarcinoma

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