基于双参数MRI评估直肠磁敏感伪影对前列腺癌诊断影响的研究  

Influence of rectal susceptibility artifacts on diagnosis of prostate cancer based on biparametric magnetic resonance imaging

作　　者：汪征 胡磊 陆蓬[1,2] 刘松[1,2] 付成志 余松 余成新[1,2] WANG Zheng;HU Lei;LU Peng;LIU Song;FU Chengzhi;YU Song;YU Chengxin(The first Clinical Medical College of three Gorges University,Yichang 443000,China;Department of Radiology,Yichang Central people's Hospital,Yichang 443000,China;Department of Radiology,Guangdong Provincial People's Hospital,Guangzhou 519041,China)

机构地区：[1]三峡大学第一临床医学院,宜昌443000 [2]宜昌市中心人民医院放射科,宜昌443000 [3]广东省人民医院放射科,广州519041

出　　处：《磁共振成像》2024年第5期134-140,147,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82302130)。

摘　　要：目的探讨MRI直肠磁敏感伪影对于前列腺癌主观评价和深度学习计算机辅助诊断(deep learning-based computer aided diagnosis,DL-CAD)的影响。材料与方法回顾性分析685例行双参数MRI检查患者的影像资料,所有病例均通过穿刺活检或手术切片获得病理结果,由三组不同年资放射科阅片医师(阅片者1~6)分别依据前列腺成像报告和数据系统(prostate imaging report and data system,PI-RADS)v2.1版对前列腺MRI上的可疑病灶进行独立评审。另外两位阅片医师(阅片者甲、乙)对MRI上是否存在直肠伪影以及伪影程度进行评分。构建基于前列腺MRI的DL-CAD诊断模型评估直肠伪影对于深度学习诊断模型的影响。采用加权Kappa系数进行直肠伪影评估的一致性检验。采用χ^(2)检验比较不同年资阅片医师PI-RADS评分、直肠伪影评分差异。采用多读者多病例受试者工作特征曲线(multi-reader multi-case receiver operating characteristic curve,MRMC-ROC)比较不同阅片者的诊断差异。采用受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)评估DL-CAD的诊断效能。采用DeLong检验比较AUC值差异。P<0.05为差异具有统计学意义。结果本研究共纳入685例患者,其中前列腺癌组共199例,良性病变组共486例。在主观评价方面,低年资阅片者1的AUC_(无伪影)为0.772,AUC_(有伪影)为0.644,差异具有统计学意义(P=0.023)。低年资阅片者2的AUC_(无伪影)为0.809,AUC_(有伪影)为0.682,差异具有统计学意义(P=0.007)。而中高年资阅片者诊断效能差异均无统计学意义(P>0.05)。在不同程度的直肠伪影评估方面,所有医师的诊断效能AUC差异均无统计学意义(0.071≤P<0.973)。基于主观评分标准,两位医师对直肠伪影评分一致性为0.851。在直肠伪影亚组分析方面,外周带无伪影区域AUC高于有伪影区域(阅片者1:0.754 vs.0.532;阅片者2:0.771 vs.0.580),且差异存在统计学�Objective:To explore the impact of rectal susceptibility artifacts on the subjective evaluation and deep learning-based computer aided diagnosis(DL-CAD)in MRI-based prostate cancer diagnosis.Materials and Methods:A retrospective analysis was conducted on 685 patients who underwent biparametric magnetic resonance imaging(bpMRI).All patients have confirmed pathological results via either biopsy or surgical resection.Three groups of radiologists(Reader 1-6)with varying years of experience independently reviewed suspicious lesions on prostate MRI according to the Prostate Imaging Reporting and Data System(PI-RADS)version 2.1.The other two readers scored whether there were rectal artifacts on MRI and the degree of artifacts.A DL-CAD model based on prostate MRI was constructed to evaluate the impact of rectal artifacts on the deep learning-based diagnostic model.The weighted Kappa coefficient was used for the consistency test of rectal artifact assessment.Differences in PI-RADS scores and rectal artifact scores among radiologists with different years of experience were compared using the chi-square test.The diagnostic differences among readers were compared using the multi-reader multi-case receiver operating characteristic curve(MRMC-ROC).The area under the curve(AUC)was used to evaluate the diagnostic performance of DL-CAD.The DeLong test was used to compare the differences in AUC values.A significance level of P<0.05 was considered statistically significant.Results:This study included a total of 685 patients,comprising 199 cases of prostate cancer and 486 cases of benign lesions.In subjective evaluation,the AUC for junior Reader 1 was 0.772 without artifacts and 0.644 with artifacts,a statistically significant difference(P=0.023),while the AUC for junior Reader 2 was 0.809 without artifacts and 0.682 with artifacts,a statistically significant difference(P=0.007).The difference was not statistically significant(P>0.05)between the diagnostic performance of the middle and senior readers.Regarding the assessment of diff

关 键 词：直肠磁敏感伪影 前列腺癌 磁共振成像 前列腺成像报告和数据系统 深度学习 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]