Assessment of salivary gland tumors using MRI and CT: impact of experience on diagnostic accuracy

作者：Vogl Thomas J.^*; Albrecht Moritz H.; Nour-Eldin Nour-El-din A.; Ackermann Hanns; Maataoui Adel; Stoever Timo; Bickford Matthew W.; Stark-Paulsen Tatjana

来源：Radiologia Medica, 2018, 123(2): 105-116.

DOI：10.1007/s11547-017-0813-z

• MRI
• CT
• Salivary gland tumor
• Radiological experience
• Diagnostic accuracy

To analyze the accuracy of radiological diagnosis in MRI and CT studies of salivary gland tumors depending on the radiologist's experience.
Three radiologists with differing experience (R1 > 20, R2 > 11, and R3 > 7 years, respectively) retrospectively reviewed 128 cases (116 MRI, 12 CT studies) with suspected salivary gland tumors regarding dignity and classification using histopathology as a reference standard. Sensitivity, specificity, positive/negative predictive value and inter-observer agreement (using Cohen's kappa) were calculated to compare diagnostic performance.
Lesions were benign in 87 and in 23 cases malignant. Neoplasia was absent in 18 cases (15 cases without neoplasia and 3 cases without disease). The highest inter-observer agreement for determining dignity using CT was found between R1 and R2 (kappa = 0.74, p < 0.001), and the lowest between R2 and R3 (kappa = 0.28, p < 0.001). MRI sensitivity/specificity for classifying pleomorphic adenomas was as follows: R1 (100%/100%), R2 (76.92%/87.01%), R3 (43.53%/67.53%), and for CT: R1 (100%/100%), R2 (100%/88.89%), R3 (66.67%/88.89%; for Warthin's tumor using MRI: R1 (100%/97.44%), R2 (68.42%/83.33%), R3 (50.00%/67.95%), and using CT: R1 (100%/100%), R2 (50.00%/100%), R3 (100%/100%; for squamous cell carcinomas using MRI: R1 (100%/100%), R2 (75.00%/97.12%), R3 (75.00%/99.04%), and using CT: R1 (100%/100%), R2 (66.67%/88.89%), R3 (66.67%/66.67%). The highest agreement was found between R1 and R2 for MRI (kappa = 0.62, p < 0.001), and the lowest between R1 and R3 at MRI (kappa = 0.28, p < 0.001).
Diagnostic accuracy in the assessment of salivary gland tumors strongly depends on the observer's expertise and increases with higher experience.

• 出版日期2018-2