scholarly journals Can New ENZIAN Score 2020 Represent A Staging System Improving MRI Structured Report?

2021 ◽  
Vol 18 (19) ◽  
pp. 9949
Author(s):  
Lucia Manganaro ◽  
Veronica Celli ◽  
Miriam Dolciami ◽  
Roberta Ninkova ◽  
Giada Ercolani ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Staging System ◽  
Structured Reporting ◽  
Deep Endometriosis ◽  
Tubal Patency ◽  
Shared Language ◽  
Pelvic Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Progestin Therapy ◽  
Histopathological Results

Structured reporting systems for endometriotic disease are gaining a central role in diagnostic imaging: our aim is to evaluate applicability and the feasibility of the recent ENZIAN score (2020) assessed by MRI. A total of 60 patients with suspected tubo–ovarian/deep endometriosis were retrospectively included in our study according to the following criteria: availability of MR examination; histopathological results from laparoscopic or surgical treatment; patients were not assuming estro-progestin or progestin therapy. Three different readers (radiologists with 2-, 5-, and 20-years of experience in pelvic imaging) have separately assigned a score according to the ENZIAN score (revised 2020) for all lesions detected by magnetic resonance imaging (MRI). Our study showed a high interobserver agreement and feasibility of the recent ENZIAN score applied to MRI; on the other hand, our experience highlighted some limitations mainly due to MRI’s inability to assess tubal patency and mobility, as required by the recent score (2020). In view of the limitations which arose from our study, we propose a modified MRI-ENZIAN score that provides a complete structured reporting system, more suitable for MRI. The high interobserver agreement of the recent ENZIAN score applied to MRI confirms its validity as a complete staging system for endometriosis, offering a shared language between radiologists and surgeons.

Agreement between magnetic resonance imaging, myelography, and surgery for detecting recurrent, thoracolumbar intervertebral disc extrusion in dogs

2013 ◽  
Vol 26 (01) ◽  
pp. 12-18 ◽  
Author(s):  
B. A. Brisson ◽  
S. G. Nykamp ◽  
D. Reynolds
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intervertebral Disc ◽  
Interobserver Agreement ◽  
Surgical Decompression ◽  
Diagnostic Methods ◽  
Resonance Imaging ◽  
Disc Disease ◽  
Recurrent Lesion ◽  
Magnetic Resonance Imaging Mri

Summary Objectives: Although magnetic resonance imaging (MRI) is reported to be superior to myelography to determine the location and site of first time disc herniation, comparison of these diagnostic methods in cases of recurrent intervertebral disc disease (IVD) herniation after a first surgery has not been evaluated. The objective was to compare the diagnostic accuracy of MRI and myelography in a series of dogs undergoing repeat surgical decompression for recurrent IVD extrusion when compared to the gold standard of surgery. Methods: Ten dogs with recurrent IVD herniation underwent MRI and myelography followed by surgical decompression. Three observers reviewed the images to determine the site and side of the first surgery and the recurrent lesion. Agreement was determined by calculating a kappa (κ) score. Results: Substantial interobserver agreement was noted for recurrent lesion site using MRI and myelography (κ = 0.77 vs. 0.73) and when comparing MRI and myelography to the reported surgical site (κ = 0.73 vs. 0.67). Interobserver agreement was greater with MRI for circumferential location compared to myelography (κ = 0.76 vs. 0.43), similar to what was found when comparing to surgical side (κ = 0.82 vs. 0.49). The previous surgical site in this study had no effect on ability to identify the new lesion. Clinical significance: Despite the limitations of MRI, there was greater agreement between observers using MRI for both the recurrent and first lesion.

MRI may be able to identify the origin of neuroendocrine tumor liver metastases

2020 ◽  
Author(s):  
Maxime Barat ◽  
Philippe Soyer ◽  
Fatima Al Sharhan ◽  
Benoit Terris ◽  
Ammar Oudjit ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Neuroendocrine Tumors ◽  
Interobserver Agreement ◽  
Validation Cohort ◽  
Univariate Analysis ◽  
Intraclass Correlation ◽  
Hepatic Metastases ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objectives: To discriminate hepatic metastases from pancreatic neuroendocrine tumors (pNET) and hepatic metastases from midgut neuroendocrine tumors (mNET) with magnetic resonance imaging (MRI). Methods: MRI examinations of 24 patients with hepatic metastases from pNET were quantitatively and qualitatively assessed by two blinded readers and compared to those obtained in 23 patients with hepatic metastases from mNET. Inter-reader agreement was calculated with kappa and intraclass correlation coefficient (ICC). Sensitivity, specificity and accuracy of each variable for the diagnosis of hepatic metastasis from pNET were calculated. Associations between variables and primary tumor (i.e., pNET vs. mNET) were assessed at univariate and multivariate analysis. A nomogram was developed and validated using an external cohort of 20 patients with pNET and 20 patients with mNET. Results: Interobserver agreement was strong to perfect (k=0.893-1) for qualitative criteria and excellent for quantitative variables (ICC: 0.9817-0.9996). At univariate analysis, homogeneity on T1-weighted images was the most discriminating variable for the diagnosis of pNET (OR, 6.417; P=0.013) with greatest sensitivity (88%; 21/24; 95% CI: 68-97%). At multivariate analysis, tumor homogeneity on T1-weighted images (P=0.007; OR, 17.607; 95%CI: 2.179–142.295) and target sign on DW images (P=0.007; OR, 19.869; 95%CI: 2.305–171.276) were independently associated with pNET. Nomogram yielded a corrected AUC of 0.894 (95%CI: 0.796–0.992) for the diagnosis of pNET in the training cohort and 0.805 (95%CI: 0.662–0.948) in the validation cohort. Conclusions: MRI provides qualitative features that can help discriminate between hepatic metastases from pNET and those from mNET.

scholarly journals Interobserver and intraobserver comparison of imaging glenoid morphology, glenoid version and humeral head subluxation

2018 ◽  
Vol 11 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Paul J Cagle ◽  
Birgit Werner ◽  
Dave R Shukla ◽  
Daniel A London ◽  
Bradford O Parsons ◽  
...  
Keyword(s):  
Humeral Head ◽  
Interobserver Agreement ◽  
Weighted Kappa ◽  
Similar Efficacy ◽  
Ct Images ◽  
Glenoid Version ◽  
Kappa Value ◽  
Glenoid Morphology ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Background Glenoid morphology, glenoid version and humeral head subluxation represent important parameters for the treating physician. The most common method of assessing glenoid morphology is the Walch classification which has only been validated with computed tomography (CT). Methods CT images and magnetic resonance imaging (MRI) images of 25 patients were de-identified and randomized. Three reviewers assessed the images for each parameter twice. The Walch classification was assessed with a weighted kappa value. Glenoid version and humeral head subluxation were comparted with a reproducibility coefficient. Results The Walch classification demonstrated almost perfect intraobserver agreement for MRI and CT images (k = 0.87). Weighted interobserver agreement values for the Walch classification were fair for CT and MRI (k = 0.34). The weighted reproducibility coefficient for glenoid version measured 9.13 (CI 7.16–12.60) degrees for CT and 13.44 (CI 10.54–18.55) degrees for MRI images. The weighted reproducibility coefficient for percentage of humeral head subluxation was 17.43% (CI 13.67–24.06) for CT and 18.49% (CI 14.5–25.52) for MRI images. Discussion CT and MRI images demonstrated similar efficacy in classifying glenoid morphology, measuring glenoid version and measuring posterior humeral head subluxation. MRI can be used as an alternative to CT for measuring these parameters.

The Role of 3.0T MRI in the Assessment of Deep Endometriosis Located on the Uterosacral Ligaments

2013 ◽  
Vol 5 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Lucia Manganaro ◽  
Valeria Vinci ◽  
Silvia Bernardo ◽  
Paola Storelli ◽  
Eliana Fuggetta ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Deep Infiltrating Endometriosis ◽  
Ovarian Endometriosis ◽  
Deep Endometriosis ◽  
Uterosacral Ligaments ◽  
3.0 T ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Purpose To assess the diagnostic accuracy of 3.0T magnetic resonance imaging (MRI) in assessing the involvement of uterosacral ligaments (USLs) in deep infiltrating endometriosis (DIE). Methods Between July 2010 and July 2012, 42 women, aged between 19 and 45 years (mean age 28 years), with a diagnosis of cystic ovarian endometriosis and scheduled for laparoscopic treatment, underwent pre-operative 3.0-T MRI examination. USL was considered normal when it was not visible or when it was thin and regular. Results We found USL involvement in 20/42 cases: 4/20 had bilateral involvement, 16/20 had monolateral involvement; in the right ligament in 9/16 cases and in the left in 7/16. Asymmetric morphology was found in 17 patients with an arciform shape associated with increased thickness of the ligament. A thickness >3 mm was considered positive. These patients also presented thickening of the torus uterinus region. In three cases complete cul de sac obliteration led to loss of tissue plane which hindered identification of the USLs. Comparison with laparoscopy findings enabled us to achieve the following statistical values: 94.7% sensitivity, 91.3% specificity, 90.0% positive predictive value, 95.4% negative predictive value, and 93% diagnostic accuracy. Conclusions Optimal visualization of USLs was obtained on para-axial scans on T2W and T1W sequences which allowed an optimal anatomic visualization. In our study we demonstrated that 3.0T imaging enabled an optimal assessment of USL involvement to select patients for the correct kind of surgery or follow-up of these patients.

scholarly journals Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging

2021 ◽  
Vol 24 (2) ◽  
pp. 98-105
Author(s):  
Hassanin Alkaduhimi ◽  
Aïmane Saarig ◽  
Ihsan Amajjar ◽  
Just A. van der Linde ◽  
Marieke F. van Wier ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Patient Characteristics ◽  
Accurate Diagnosis ◽  
Bonferroni Correction ◽  
Resonance Imaging ◽  
Similar Appearance ◽  
Magnetic Resonance Imaging Mri

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss’ kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

scholarly journals Ultrasonographic staging: a new staging system for deep endometriosis

2011 ◽  
Vol 1221 (1) ◽  
pp. 61-69 ◽  
Author(s):  
Maria Elisabetta Coccia ◽  
Francesca Rizzello
Keyword(s):  
Staging System ◽  
Deep Endometriosis

Contrast-Enhanced Ultrasound (CEUS) and Quantitative Perfusion Analysis in Patients with Suspicion for Prostate Cancer

2018 ◽  
Vol 40 (03) ◽  
pp. 340-348 ◽  
Author(s):  
Andreas Maxeiner ◽  
Thomas Fischer ◽  
Julia Schwabe ◽  
Alexander Daniel Jacques Baur ◽  
Carsten Stephan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Statistical Significance ◽  
Contrast Enhanced Ultrasound ◽  
Quantitative Perfusion ◽  
Time To Peak ◽  
Guided Biopsy ◽  
Peak Enhancement ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri ◽  
Histopathological Results

Abstract Purpose The aim of this study was to investigate contrast-enhanced ultrasound (CEUS) parameters acquired by software during magnetic resonance imaging (MRI) US fusion-guided biopsy for prostate cancer (PCa) detection and discrimination. Materials and Methods From 2012 to 2015, 158 out of 165 men with suspicion for PCa and with at least 1 negative biopsy of the prostate were included and underwent a multi-parametric 3 Tesla MRI and an MRI/US fusion-guided biopsy, consecutively. CEUS was conducted during biopsy with intravenous bolus application of 2.4 mL of SonoVue® (Bracco, Milan, Italy). In the latter CEUS clips were investigated using quantitative perfusion analysis software (VueBox, Bracco). The area of strongest enhancement within the MRI pre-located region was investigated and all available parameters from the quantification tool box were collected and analyzed for PCa and its further differentiation was based on the histopathological results. Results The overall detection rate was 74 (47 %) PCa cases in 158 included patients. From these 74 PCa cases, 49 (66 %) were graded Gleason ≥ 3 + 4 = 7 (ISUP ≥ 2) PCa. The best results for cancer detection over all quantitative perfusion parameters were rise time (p = 0.026) and time to peak (p = 0.037). Within the subgroup analysis (> vs ≤ 3 + 4 = 7a (ISUP 2)), peak enhancement (p = 0.012), wash-in rate (p = 0.011), wash-out rate (p = 0.007) and wash-in perfusion index (p = 0.014) also showed statistical significance. Conclusion The quantification of CEUS parameters was able to discriminate PCa aggressiveness during MRI/US fusion-guided prostate biopsy.

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