Abstract
Purpose
To evaluate the impact of contrast agent selection on radiologists’ confidence in assessing liver lesions on follow-up magnetic resonance imaging (MRI) studies in patients with neuroendocrine tumors.
Methods
This Institutional Review Board-approved, retrospective study performed at a tertiary cancer center and a quaternary care urban academic hospital included all 694 follow-up abdominal MRI studies from 179 patients with gastroenteropancreatic neuroendocrine tumor performed from 01/01/2010 to 05/31/2015. Primary outcome measure was radiologists’ confidence in assessing liver lesions on follow-up MRI. MRI reports were reviewed to abstract radiologists’ confidence, classified as “equivocal” if any equivocal connotation (mention of limitation due to differences in contrast agent or follow-up recommendation with specific contrast agent) was present; or “unequivocal” if a precise, confident comparison to prior was documented without the use of ambiguous terms. A fellowship-trained radiologist separately evaluated 100 randomly selected reports and images to calculate interobserver agreement with the report classification (equivocal vs. unequivocal) and with the original MRI report, respectively. Chi-square test was used to compare the proportion of equivocal reports when “same” or “different” contrast agent was used for successive examinations.
Results
Rates of equivocal reports were higher when different contrast agents were used for successive examinations compared to examinations with same contrast agent (13.2% [21/159] vs. 1.8% [10/535]; p < 0.0001). There was very good interobserver agreement for assessment of radiologist confidence (κ = 0.92 for report review, κ = 0.82 for image review).
Conclusions
Consistent use of contrast agent for follow-up MRIs allows more confident assessment of liver lesions in patients with neuroendocrine tumors.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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The requirement for informed consent was waived for this IRB-approved retrospective study.
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Balthazar, P., Shinagare, A.B., Tirumani, S.H. et al. Gastroenteropancreatic neuroendocrine tumors: impact of consistent contrast agent selection on radiologists’ confidence in hepatic lesion assessment on restaging MRIs. Abdom Radiol 43, 1386–1392 (2018). https://doi.org/10.1007/s00261-017-1302-5
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DOI: https://doi.org/10.1007/s00261-017-1302-5