The purpose of this study was to investigate the utility of reconstructed CT images perpendicular to the artery for assessing arterial involvement from pancreatic cancer and compare the interobserver variability between it and the current diagnostic imaging method. This retrospective study included patients with pancreatic cancer in the pancreatic body or tail who underwent preoperative pancreatic protocol CT and distal pancreatectomy. Five radiologists used axial and coronal CT images (current method) and perpendicular reconstructed CT images (proposed method) to determine if the degree of solid soft-tissue contact with the splenic artery was ≤180° or >180°. The generalized estimating equations were used to compare the diagnostic performance of solid soft-tissue contact >180° between the current and proposed methods. Fleiss’ĸstatistics were used to assess interobserver variability. The sensitivity and negative predictive value for diagnosing solid soft-tissue contact >180° were higher (p< 0.001 for each) and the specificity (p= 0.003) and positive predictive value (p= 0.003) were lower in the proposed method than the current method. Interobserver variability was improved in the proposed method compared with the current method (ĸ= 0.87 vs. 0.67). Reconstructed CT images perpendicular to the artery showed higher sensitivity and negative predictive value for diagnosing solid soft-tissue contact >180° than the current method and demonstrated improved interobserver variability.
本研究旨在探讨垂直于动脉的重建CT图像在评估胰腺癌动脉侵犯方面的应用价值，并将其与现行影像诊断方法的观察者间变异性进行比较。这项回顾性研究纳入了胰体或胰尾胰腺癌患者，所有患者均接受了术前胰腺CT增强扫描和远端胰腺切除术。五位放射科医师分别使用轴位和冠状位CT图像（现行方法）以及垂直于动脉的重建CT图像（新方法）来判断实体软组织与脾动脉的接触角度是否≤180°或>180°。采用广义估计方程比较现行方法与新方法对实体软组织接触>180°的诊断效能，并使用Fleiss'ĸ统计量评估观察者间变异性。结果显示，新方法诊断实体软组织接触>180°的敏感度和阴性预测值均更高（p值均<0.001），而特异度（p=0.003）和阳性预测值（p=0.003）低于现行方法。与现行方法相比，新方法的观察者间变异性得到改善（ĸ值分别为0.87 vs. 0.67）。垂直于动脉的重建CT图像在诊断实体软组织接触>180°方面较现行方法具有更高的敏感度和阴性预测值，并展现出更优的观察者间一致性。
肿瘤(癌症)患者之家