Background:Vesical Imaging-Reporting and Data System(Ⅵ-RADS)was developed as a structured reporting tool to anticipate the possibility of muscle invasion.This study is aimed to investigate the diagnostic accuracy of...Background:Vesical Imaging-Reporting and Data System(Ⅵ-RADS)was developed as a structured reporting tool to anticipate the possibility of muscle invasion.This study is aimed to investigate the diagnostic accuracy ofⅥ-RADS for discriminating T2 from T1 bladder cancer.Materials and methods:Scopus,Web of Science,PubMed,and Embase were searched on October 4,2021,for studies with the following characteristics:(1)bladder cancer patient population,(2)Ⅵ-RADS as an index test,(3)retransurethral resection of bladder tumor/cystectomy as a reference,and(4)adequateⅥ-RADS score data for T1 and T2 lesions.The analyses were performed using the binary regression model of MIDAS in Stata.Results:Six studies with 624 magnetic resonance imaging reports were included.The receiver operating characteristics curve for differentiation of T2 from T1 bladder cancer showed an area under the curve of 0.93(95%confidence interval[CI],0.91-0.95)for aⅥ-RADS≥3 and 0.75(95%CI,0.71-0.79)for aⅥ-RADS≥4.AⅥ-RADS≥3 showed high sensitivity of 93%(95%CI,85%-97%),specificity of 61%(95%CI,30%-86%),positive likelihood ratio of 2.4(95%CI,1.1-5.3),and negative likelihood ratio of 0.11(95%CI,0.05-0.24).A total of 10.4%of T2 lesions were scored asⅥ-RADS 2,while 10%of T1 lesions were scored asⅥ-RADS 4 or 5.Conclusions:TheⅥ-RADS≥3 has high accuracy and sensitivity for detecting muscle invasion in borderline populations of T1 or T2 bladder cancer.Thus,theⅥ-RADS could be a good non-invasive screening test for the detection of T2 urothelial lesions.展开更多
The overdiagnosis of prostate cancer(PCa)caused by nonspecific elevation serum prostate-specific antigen(PSA)and the overtreatment of indolent PCa have become a global problem that needs to be solved urgently.We aimed...The overdiagnosis of prostate cancer(PCa)caused by nonspecific elevation serum prostate-specific antigen(PSA)and the overtreatment of indolent PCa have become a global problem that needs to be solved urgently.We aimed to construct a prediction model and provide a risk stratification system to reduce unnecessary biopsies.In this retrospective study,clinical data of 1807 patients from three Chinese hospitals were used.The final model was built using stepwise logistic regression analysis.The apparent performance of the model was assessed by receiver operating characteristic curves,calibration plots,and decision curve analysis.Finally,a risk stratification system of clinically significant prostate cancer(csPCa)was created,and diagnosis-free survival analyses were performed.Following multivariable screening and evaluation of the diagnostic performances,a final diagnostic model comprised of the PSA density and Prostate Imaging-Reporting and Data System(PI-RADS)score was established.Model validation in the development cohort and two external cohorts showed excellent discrimination and calibration.Finally,we created a risk stratification system using risk thresholds of 0.05 and 0.60 as the cut-off values.The follow-up results indicated that the diagnosis-free survival rate for csPCa at 12 months and 24 months postoperatively was 99.7%and 99.4%,respectively,for patients with a risk threshold below O.05 after the initial negative prostate biopsy,which was significantly better than patients with higher risk.Our diagnostic model and risk stratification system can achieve a personalized risk calculation of csPCa.It provides a standardized tool for Chinese patients and physicians when considering thenecessity of prostatebiopsy.展开更多
Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast ...Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.展开更多
Objective To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate(mpMRIp)scans over time.Methods An experienced geni...Objective To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate(mpMRIp)scans over time.Methods An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans using Prostate Imaging-Reporting and Data System version 2(PI-RADS v2)after 5 years of further experience comprising>1000 scans.Intraobserver agreement was measured using Cohen's kappa.Sensitivity,specificity,negative predictive value(NPV),positive predictive value(PPV),and accuracy were calculated,and comparison of sensitivity was performed using McNemar's test.Results Ninety-six mpMRIp scans were included in our final analysis.Of the 96 patients,53(55.2%)patients underwent subsequent biopsy(n=43)or prostatectomy(n=15),with 73 lesions targeted.Moderate agreement(Cohen's kappa 0.55)was seen in the number of lesions identified at initial reporting and on re-reading(81 vs.39 total lesions;and 71 vs.37 number of PI-RADS≥3 lesions).For clinically significant prostate cancer,re-reading demonstrated an increase in specificity(from 43%to 89%)and PPV(from 62%to 87%),but a decrease in sensitivity(from 94%to 72%,p=0.01)and NPV(from 89%to 77%).Conclusion The intraobserver agreement for a novice to experienced radiologist reporting mpMRIp using PI-RADS v2 is moderate.Reduced sensitivity is off-set by improved specificity and PPV,which validate mpMRIp as a gold standard for prebiopsy screening.展开更多
The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Although the best chance for long-term survival is early detection, screening high-risk populations to detect HCC when it is most treatable still ha...The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Although the best chance for long-term survival is early detection, screening high-risk populations to detect HCC when it is most treatable still has only limited success. Once detected within the cirrhotic liver, many observations still defy correct characterization, due in part to a history of nonstandarized nomenclature and reporting patterns. Recently, however, an initiative by the American College of Radiology, Liver Imaging-Reporting and Data System (LI-RADS), has begun to remedy these inadequacies. Here, we review LI-RADS, and focus in particular on the difficult nodule, i.e., a radiological observation that challenges our current diagnostic ability, and review essential technical imaging features that aid in the diagnosis of early HCC.展开更多
Diffusion-weighted imaging(DWI) is considered to be one of the dominant modalities used in prostate cancer(PCa) detection and the assessment of lesion aggressiveness,especially for peripheral zone(PZ) PCa.Computer-aid...Diffusion-weighted imaging(DWI) is considered to be one of the dominant modalities used in prostate cancer(PCa) detection and the assessment of lesion aggressiveness,especially for peripheral zone(PZ) PCa.Computer-aided diagnosis(CAD),which is capable of automatically extracting and evaluating image features,can integrate multiple parameters and improve the detection of PCa.In this study,13 quantitative image features were extracted from DWI by CAD,and diagnostic efficacy was analyzed in both the PZ and transition zone(TZ).The results demonstrated that there was a significant difference(P<0.05) between PCa and non-PCa for nine of the 13 features in the PZ and five of the 13 features in the TZ.Besides,the prediction outcome of CAD had a strong correlation with the DWI scores that were graded by experienced radiologists according to the Prostate Imaging-Reporting and Data System Version 2(PI-RADS v2).展开更多
文摘Background:Vesical Imaging-Reporting and Data System(Ⅵ-RADS)was developed as a structured reporting tool to anticipate the possibility of muscle invasion.This study is aimed to investigate the diagnostic accuracy ofⅥ-RADS for discriminating T2 from T1 bladder cancer.Materials and methods:Scopus,Web of Science,PubMed,and Embase were searched on October 4,2021,for studies with the following characteristics:(1)bladder cancer patient population,(2)Ⅵ-RADS as an index test,(3)retransurethral resection of bladder tumor/cystectomy as a reference,and(4)adequateⅥ-RADS score data for T1 and T2 lesions.The analyses were performed using the binary regression model of MIDAS in Stata.Results:Six studies with 624 magnetic resonance imaging reports were included.The receiver operating characteristics curve for differentiation of T2 from T1 bladder cancer showed an area under the curve of 0.93(95%confidence interval[CI],0.91-0.95)for aⅥ-RADS≥3 and 0.75(95%CI,0.71-0.79)for aⅥ-RADS≥4.AⅥ-RADS≥3 showed high sensitivity of 93%(95%CI,85%-97%),specificity of 61%(95%CI,30%-86%),positive likelihood ratio of 2.4(95%CI,1.1-5.3),and negative likelihood ratio of 0.11(95%CI,0.05-0.24).A total of 10.4%of T2 lesions were scored asⅥ-RADS 2,while 10%of T1 lesions were scored asⅥ-RADS 4 or 5.Conclusions:TheⅥ-RADS≥3 has high accuracy and sensitivity for detecting muscle invasion in borderline populations of T1 or T2 bladder cancer.Thus,theⅥ-RADS could be a good non-invasive screening test for the detection of T2 urothelial lesions.
基金This study was supported by the Key Research and Development Program of Anhui Province(No.202204295107020003)the National Natural Science Foundation of Anhui Province(No.2108085MH293)+1 种基金the Distinguished Young Scholars Fund of Anhui Province(No.2022AH020078)the Key health Project of Anhui Province(AHWJ2022a037).
文摘The overdiagnosis of prostate cancer(PCa)caused by nonspecific elevation serum prostate-specific antigen(PSA)and the overtreatment of indolent PCa have become a global problem that needs to be solved urgently.We aimed to construct a prediction model and provide a risk stratification system to reduce unnecessary biopsies.In this retrospective study,clinical data of 1807 patients from three Chinese hospitals were used.The final model was built using stepwise logistic regression analysis.The apparent performance of the model was assessed by receiver operating characteristic curves,calibration plots,and decision curve analysis.Finally,a risk stratification system of clinically significant prostate cancer(csPCa)was created,and diagnosis-free survival analyses were performed.Following multivariable screening and evaluation of the diagnostic performances,a final diagnostic model comprised of the PSA density and Prostate Imaging-Reporting and Data System(PI-RADS)score was established.Model validation in the development cohort and two external cohorts showed excellent discrimination and calibration.Finally,we created a risk stratification system using risk thresholds of 0.05 and 0.60 as the cut-off values.The follow-up results indicated that the diagnosis-free survival rate for csPCa at 12 months and 24 months postoperatively was 99.7%and 99.4%,respectively,for patients with a risk threshold below O.05 after the initial negative prostate biopsy,which was significantly better than patients with higher risk.Our diagnostic model and risk stratification system can achieve a personalized risk calculation of csPCa.It provides a standardized tool for Chinese patients and physicians when considering thenecessity of prostatebiopsy.
文摘Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.
基金This research has been kindly supported by a grant from the St Vincent's Research Endowment Fund(approval number 55.2014).
文摘Objective To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate(mpMRIp)scans over time.Methods An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans using Prostate Imaging-Reporting and Data System version 2(PI-RADS v2)after 5 years of further experience comprising>1000 scans.Intraobserver agreement was measured using Cohen's kappa.Sensitivity,specificity,negative predictive value(NPV),positive predictive value(PPV),and accuracy were calculated,and comparison of sensitivity was performed using McNemar's test.Results Ninety-six mpMRIp scans were included in our final analysis.Of the 96 patients,53(55.2%)patients underwent subsequent biopsy(n=43)or prostatectomy(n=15),with 73 lesions targeted.Moderate agreement(Cohen's kappa 0.55)was seen in the number of lesions identified at initial reporting and on re-reading(81 vs.39 total lesions;and 71 vs.37 number of PI-RADS≥3 lesions).For clinically significant prostate cancer,re-reading demonstrated an increase in specificity(from 43%to 89%)and PPV(from 62%to 87%),but a decrease in sensitivity(from 94%to 72%,p=0.01)and NPV(from 89%to 77%).Conclusion The intraobserver agreement for a novice to experienced radiologist reporting mpMRIp using PI-RADS v2 is moderate.Reduced sensitivity is off-set by improved specificity and PPV,which validate mpMRIp as a gold standard for prebiopsy screening.
文摘The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Although the best chance for long-term survival is early detection, screening high-risk populations to detect HCC when it is most treatable still has only limited success. Once detected within the cirrhotic liver, many observations still defy correct characterization, due in part to a history of nonstandarized nomenclature and reporting patterns. Recently, however, an initiative by the American College of Radiology, Liver Imaging-Reporting and Data System (LI-RADS), has begun to remedy these inadequacies. Here, we review LI-RADS, and focus in particular on the difficult nodule, i.e., a radiological observation that challenges our current diagnostic ability, and review essential technical imaging features that aid in the diagnosis of early HCC.
文摘Diffusion-weighted imaging(DWI) is considered to be one of the dominant modalities used in prostate cancer(PCa) detection and the assessment of lesion aggressiveness,especially for peripheral zone(PZ) PCa.Computer-aided diagnosis(CAD),which is capable of automatically extracting and evaluating image features,can integrate multiple parameters and improve the detection of PCa.In this study,13 quantitative image features were extracted from DWI by CAD,and diagnostic efficacy was analyzed in both the PZ and transition zone(TZ).The results demonstrated that there was a significant difference(P<0.05) between PCa and non-PCa for nine of the 13 features in the PZ and five of the 13 features in the TZ.Besides,the prediction outcome of CAD had a strong correlation with the DWI scores that were graded by experienced radiologists according to the Prostate Imaging-Reporting and Data System Version 2(PI-RADS v2).
