Franco Gambazzi, Lukas D Frey, Matthias Bruehlmeier, Wolf-Dieter Janthur, Juerg Heuberger, Andres Spirig, Richard Williams, Roland Zweifel, Bettina Boerner, Gabrielo M Tini, Sarosh Irani
{"title":"治疗后非小细胞肺癌监测的图像分析:胸部多学科肿瘤委员会审查的专家解释。","authors":"Franco Gambazzi, Lukas D Frey, Matthias Bruehlmeier, Wolf-Dieter Janthur, Juerg Heuberger, Andres Spirig, Richard Williams, Roland Zweifel, Bettina Boerner, Gabrielo M Tini, Sarosh Irani","doi":"10.1186/s40248-019-0198-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data show that the initial specialist's image interpretation and final multidisciplinary tumor board (MTB) assessment can vary substantially in the pretherapeutic cancer setting. The aim of this <i>post hoc</i> analysis was to investigate the concordance of the specialist's and MTB's image interpretations in patients undergoing systematic posttreatment lung cancer image surveillance.</p><p><strong>Methods: </strong>In the initial prospective study, lung cancer patients who had received curative-intent treatment were randomly assigned to undergo either contrast-enhanced computed tomography (CE-CT) or integrated 18<sup>F</sup>-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). Imaging was performed every 6 months for 2 years, and all imaging studies were finally assessed by our MTB. This <i>post hoc</i> analysis assessed differences between the initial specialist's image interpretation and the final MTB's image interpretation.</p><p><strong>Results: </strong>In 89 patients, 266 imaging studies (129 PET-CT, 137 CE-CT) were analyzed. In 87.2% (88.4, 86.1%) of the studies, complete concordance was found. Out of the 12.8% (11.6, 13.9%) with discordant results, 7.5% (6.9, 8.0%) had implications for alterations in patient management (major disagreements).Twenty major disagreements were detected in 17 study patients. Retrospectively, in eight out of these 17 (47%) patients, in contrast to the MTB's view, the specialist's interpretation was more appropriate, whereas in nine out of 17 patients (53%), the MTB's interpretation was more accurate.</p><p><strong>Conclusions: </strong>In an experienced MTB, the agreement between imaging specialists and the rest of the MTB with regard to the interpretation of images is high in a setting of posttreatment lung cancer image surveillance. It seems that in cases of disagreements, the rates of more accurate interpretation are well balanced between imaging specialists and the MTB.</p><p><strong>Trial registration: </strong>ISRCTN16281786, Date 23. February 2017.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2019-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40248-019-0198-z","citationCount":"4","resultStr":"{\"title\":\"Image analysis in posttreatment non-small cell lung cancer surveillance: specialists' interpretations reviewed by the thoracic multidisciplinary tumor board.\",\"authors\":\"Franco Gambazzi, Lukas D Frey, Matthias Bruehlmeier, Wolf-Dieter Janthur, Juerg Heuberger, Andres Spirig, Richard Williams, Roland Zweifel, Bettina Boerner, Gabrielo M Tini, Sarosh Irani\",\"doi\":\"10.1186/s40248-019-0198-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Data show that the initial specialist's image interpretation and final multidisciplinary tumor board (MTB) assessment can vary substantially in the pretherapeutic cancer setting. The aim of this <i>post hoc</i> analysis was to investigate the concordance of the specialist's and MTB's image interpretations in patients undergoing systematic posttreatment lung cancer image surveillance.</p><p><strong>Methods: </strong>In the initial prospective study, lung cancer patients who had received curative-intent treatment were randomly assigned to undergo either contrast-enhanced computed tomography (CE-CT) or integrated 18<sup>F</sup>-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). Imaging was performed every 6 months for 2 years, and all imaging studies were finally assessed by our MTB. This <i>post hoc</i> analysis assessed differences between the initial specialist's image interpretation and the final MTB's image interpretation.</p><p><strong>Results: </strong>In 89 patients, 266 imaging studies (129 PET-CT, 137 CE-CT) were analyzed. In 87.2% (88.4, 86.1%) of the studies, complete concordance was found. Out of the 12.8% (11.6, 13.9%) with discordant results, 7.5% (6.9, 8.0%) had implications for alterations in patient management (major disagreements).Twenty major disagreements were detected in 17 study patients. Retrospectively, in eight out of these 17 (47%) patients, in contrast to the MTB's view, the specialist's interpretation was more appropriate, whereas in nine out of 17 patients (53%), the MTB's interpretation was more accurate.</p><p><strong>Conclusions: </strong>In an experienced MTB, the agreement between imaging specialists and the rest of the MTB with regard to the interpretation of images is high in a setting of posttreatment lung cancer image surveillance. It seems that in cases of disagreements, the rates of more accurate interpretation are well balanced between imaging specialists and the MTB.</p><p><strong>Trial registration: </strong>ISRCTN16281786, Date 23. February 2017.</p>\",\"PeriodicalId\":49031,\"journal\":{\"name\":\"Multidisciplinary Respiratory Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2019-12-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1186/s40248-019-0198-z\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multidisciplinary Respiratory Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40248-019-0198-z\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2019/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multidisciplinary Respiratory Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40248-019-0198-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Image analysis in posttreatment non-small cell lung cancer surveillance: specialists' interpretations reviewed by the thoracic multidisciplinary tumor board.
Background: Data show that the initial specialist's image interpretation and final multidisciplinary tumor board (MTB) assessment can vary substantially in the pretherapeutic cancer setting. The aim of this post hoc analysis was to investigate the concordance of the specialist's and MTB's image interpretations in patients undergoing systematic posttreatment lung cancer image surveillance.
Methods: In the initial prospective study, lung cancer patients who had received curative-intent treatment were randomly assigned to undergo either contrast-enhanced computed tomography (CE-CT) or integrated 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). Imaging was performed every 6 months for 2 years, and all imaging studies were finally assessed by our MTB. This post hoc analysis assessed differences between the initial specialist's image interpretation and the final MTB's image interpretation.
Results: In 89 patients, 266 imaging studies (129 PET-CT, 137 CE-CT) were analyzed. In 87.2% (88.4, 86.1%) of the studies, complete concordance was found. Out of the 12.8% (11.6, 13.9%) with discordant results, 7.5% (6.9, 8.0%) had implications for alterations in patient management (major disagreements).Twenty major disagreements were detected in 17 study patients. Retrospectively, in eight out of these 17 (47%) patients, in contrast to the MTB's view, the specialist's interpretation was more appropriate, whereas in nine out of 17 patients (53%), the MTB's interpretation was more accurate.
Conclusions: In an experienced MTB, the agreement between imaging specialists and the rest of the MTB with regard to the interpretation of images is high in a setting of posttreatment lung cancer image surveillance. It seems that in cases of disagreements, the rates of more accurate interpretation are well balanced between imaging specialists and the MTB.
Trial registration: ISRCTN16281786, Date 23. February 2017.
期刊介绍：
Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research.
The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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