Abstract
The aim of this study was to investigate the impact of radiologic experience on the diagnostic accuracy of computed tomography (CT) vs. magnetic resonance imaging (MRI) reporting on the liver metastases of pancreatic ductal adenocarcinoma (LM of PDAC). Intra-individual CT and MRI examinations of 112 patients with clinically proven LM of PDAC were included. Four radiologists with varying years of experience (A > 20, B > 5, C > 1 and D < 1) assessed liver segments affected by LM of PDAC, as well as associated metastases occurring in each patient. Their sensitivity and specificity in evaluating the segments were compared. Cohen’s Kappa (κ) for diagnosed liver segments and Intra-class Correlation Coefficients (ICC) for the number of metastatic lesions in each patient were calculated. The radiologists’ sensitivity and specificity for the CT vs. MRI were, respectively: Reader A—94.4%, 90.3% vs. 96.6%, 94.8%; B—86.7%, 79.7% vs. 83.9%, 82.0%; C—78.0%, 76.7% vs. 83.3%, 78.9% and D—71.8%, 79.2% vs. 64.0%, 69.5%. Reviewers A and B achieved greater agreement in assessing results from the MRI (κ = 0.72, p < 0.001; ICC = 0.73, p < 0.001) vs. the CT (κ = 0.58, p < 0.001; ICC = 0.61, p < 0.001), in contrast to readers C and D (MRI: κ = 0.34, p < 0.001; ICC = 0.42, p < 0.001, and CT: κ = 0.48, p < 0.001; ICC = 0.59, p < 0.001). Our results indicate that the accurate diagnosis of LM of PDAC depends more on radiologic experience in MRI over CT scans.
Highlights
International guidelines advise contrast-enhanced computed tomography (CE-CT) for routine diagnosing and staging of pancreatic cancer, whereas magnetic resonance imaging (MRI) is mostly used for the characterization of indeterminate liver lesions [1,2]
liver metastases (LM) of pancreatic ductal adenocarcinoma (PDAC) depends more on radiologic experience in MRI over CT scans
This study aimed to investigate the impact of observer experience on diagnostic performance and inter-observer agreement in reporting LM of PDAC using CT and MRI scans because data from these imaging modalities are commonly reviewed by physicians with varying levels of experience in the clinical and radiological practice of oncology [13]
Summary
International guidelines advise contrast-enhanced computed tomography (CE-CT) for routine diagnosing and staging of pancreatic cancer, whereas magnetic resonance imaging (MRI) is mostly used for the characterization of indeterminate liver lesions [1,2]. The enhanced detection of LM could reduce the futile resection of tumors and markedly increase life expectancy. CE-CT has been widely used as a standard imaging modality to determine the stage of pancreatic cancer. Its ability to detect LM less than 1 cm in size is reported to be limited and unsatisfactory, given that its rate of accuracy currently stands at just 50% [3,4]. Liver-specific magnetic resonance contrast agents like gadoxetate disodium appear to offer great promise because of Cancers 2020, 12, 1455; doi:10.3390/cancers12061455 www.mdpi.com/journal/cancers
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