Multidisciplinary tumor boards (MTBs) facilitate decision-making among subspecialists in the care of oncology patients, but the mechanisms by which they enhance outcomes remain incompletely understood. Our aim was to measure the agreement between sarcoma MTBs and radiology reports’ disease assessment and management recommendations. This single-center IRB-approved retrospective study evaluated cases presented at a weekly sarcoma MTB from 1 August 2020 to 31 July 2021. Cases without clinical notes, imaging studies, or radiology reports were excluded. The data collected included the patient’s clinical status at the time of the MTB, the treatment response assessment by the MTB and radiologists (stable disease; partial response; complete response; progressive disease/recurrence), and the recommendations of the radiology reports and of the MTB. The agreement between the initial radiologist review and MTB on disease assessment and recommendations was analyzed using kappa statistics. In total, 283 cases met the inclusion criteria. Radiology reports provided recommendations in 34.3% of cases, which were adhered to by the ordering providers in 73.2% of cases. The agreement between MTBs and radiology reports was moderate in disease assessment (86.2% agreement; κ = 0.78;p< 0.0001) and negligible in recommendations (36% agreement; κ = 0.18;p< 0.0001). Radiologists were more likely to assign progressive disease/recurrence than MTBs (54.4% vs. 44.4%;p< 0.001) and to recommend short-term imaging follow-up more commonly than MTBs (46.4% vs. 21.7%;p< 0.001). At a tertiary care center, radiologists’ isolated interpretations of imaging findings and management recommendations frequently differ from the MTB’s consensus, reflecting the value of multidisciplinary discussions incorporating the patient’s clinical status and the available treatment options into the final radiographic assessment.
多学科肿瘤会诊（MTB）有助于肿瘤患者诊疗中各亚专科医师的决策制定，但其改善临床结局的作用机制尚未完全阐明。本研究旨在评估肉瘤MTB与影像学报告在疾病评估及治疗建议方面的一致性。这项经机构审查委员会批准的单中心回顾性研究，评估了2020年8月1日至2021年7月31日期间每周肉瘤MTB讨论的病例，排除无临床记录、影像学检查或影像报告的病例。收集的数据包括MTB讨论时患者的临床状态、MTB与放射科医师的疗效评估（疾病稳定、部分缓解、完全缓解、疾病进展/复发），以及影像报告与MTB提出的建议。采用kappa统计量分析初始放射科医师阅片与MTB在疾病评估及建议方面的一致性。共283例病例符合纳入标准。影像报告在34.3%的病例中提供了建议，其中73.2%被申请医师采纳。MTB与影像报告在疾病评估方面的一致性为中等（一致率86.2%；κ=0.78；p<0.0001），在治疗建议方面的一致性较弱（一致率36%；κ=0.18；p<0.0001）。与MTB相比，放射科医师更倾向于判定为疾病进展/复发（54.4% vs. 44.4%；p<0.001），也更常建议短期影像随访（46.4% vs. 21.7%；p<0.001）。在三级医疗中心，放射科医师对影像表现的独立解读及管理建议常与MTB共识存在差异，这体现了多学科讨论将患者临床状态及可用治疗方案纳入最终影像评估的重要价值。
肿瘤(癌症)患者之家