医学
直肠
乙状窦函数
再现性
放射科
结直肠癌
队列
危险分层
乙状结肠
核医学
癌症
外科
人工智能
内科学
计算机科学
统计
人工神经网络
数学
作者
Nino Bogveradze,Doenja M. J. Lambregts,Najim el Khababi,Raphaëla C. Dresen,Monique Maas,Miranda Kusters,Pieter J. Tanis,Regina G. H. Beets‐Tan,Femke Alberts,Frans C. H. Bakers,Nino Batiashvili,Geerard L. Beets,Regina G. H. Beets‐Tan,Shira de Bie,Nino Bogveradze,Gerlof P. T. Bosma,Vincent C. Cappendijk,Francesca Castagnoli,Ana Daushvili,Pascal G. Doornebosch
出处
期刊:Ejso
[Elsevier BV]
日期:2021-09-20
卷期号:48 (1): 237-244
被引量:20
标识
DOI:10.1016/j.ejso.2021.09.009
摘要
Abstract Purpose The sigmoid take-off (STO) was recently introduced as a preferred landmark, agreed upon by expert consensus recommendation, to discern rectal from sigmoid cancer on imaging. Aim of this study was to assess the reproducibility of the STO, explore its potential treatment impact and identify its main interpretation pitfalls. Methods Eleven international radiologists (with varying expertise) retrospectively assessed n = 155 patients with previously clinically staged upper rectal/rectosigmoid tumours and re-classified them using the STO as completely below (rectum), straddling the STO (rectosigmoid) or completely above (sigmoid), after which scores were dichotomized as rectum (below/straddling STO) and sigmoid (above STO), being the clinically most relevant distinction. A random subset of n = 48 was assessed likewise by 6 colorectal surgeons. . Results Interobserver agreement (IOA) for the 3-category score ranged from κ0.19–0.82 (radiologists) and κ0.32–0.72 (surgeons), with highest scores for the most experienced radiologists (κ0.69–0.76). Of the 155 cases, 44 (28%) were re-classified by ≥ 80% of radiologists as sigmoid cancers; 36 of these originally received neoadjuvant treatment which in retrospect might have been omitted if the STO had been applied. Main interpretation pitfalls were related to anatomical variations, borderline cases near the STO and angulation of axial imaging planes. Conclusions Good agreement was reached for experienced radiologists. Despite considerable variation among less-expert readers, use of the STO could have changed treatment in ±1/4 of patients in our cohort. Identified interpretation pitfalls may serve as a basis for teaching and to further optimize MR protocols.
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