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MRI与CT测量胰腺癌肿瘤大小的观察者间一致性：新辅助治疗前后对比

Interobserver agreement with MRI vs. CT for pancreatic tumour size measurement before and after neoadjuvant therapy.
PubMed 文献 · Eur J Radiol · 2026-04-16

单中心回顾性队列纳入50例经组织学证实的PDAC患者，比较CT与MRI在新辅助治疗前后测量肿瘤最大径的观察者间一致性。CT在治疗前一致性优秀（ICC 0.83-0.84），治疗后良好（ICC 0.65-0.66）；MRI治疗前中等至良好（最佳ICC 0.67），治疗后仅中等（最佳ICC 0.55）。结论：CT测量一致性优于MRI，且两种方法治疗前均优于治疗后。

要点

  • CT测量PDAC大小的观察者间一致性优于MRI，治疗前尤为明显。
  • 新辅助治疗后两种方法的测量一致性均下降，报告时应谨慎。
  • MRI中T1动脉期序列在治疗前一致性相对较好。

局限性

  • 单中心回顾性研究，样本量50例。

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

英文原文（摘要）· 点击展开

OBJECTIVE: To assess inter-observer agreement of pancreatic ductal adenocarcinoma (PDAC) tumour size measurement using CT and MRI, before and after neoadjuvant therapy (NAT) MATERIALS AND METHODS: In this single-centre retrospective observational cohort study, we included consecutive patients with histologically documented PDAC diagnosed in 2010-2022 and imaged by CT and MRI before and after NAT. Three blinded independent radiologists evaluated the largest tumour length on two CT acquisitions and six MRI sequences. Inter-observer agreement was assessed by the intra-class correlation coefficient (ICC) and LOAM graphs (Bland & Altmann extension for multiple observers).

RESULTS: We included 50 patients (26 females, median age 68 [61-74] y). By CT, inter-observer agreement was excellent before NAT (ICC, 0.83 [0.73-0.90] at the arterial phase and 0.84 [0.74-0.90] at the portal-venous phase) and good after NAT (ICC, 0.66 [0.52-0.78] at the arterial phase and 0.65 [0.51-0.77] at the portal-venous phase). By MRI, inter-observer agreement was moderate-to-good before NAT (T1 at the arterial phase being the best sequence; ICC, 0.67 [0.53-0.79]) and only moderate for all sequences after NAT (T1 at the late phase being the best sequence; ICC, 0.55 [0.37-0.71]).

CONCLUSION: Inter-observer agreement for PDAC size measurement was better by CT than MRI and was better, with both methods, before vs. after NAT.

来源：Eur J Radiol，查看原文。版权归原作者所有。

引用

  1. Licha A, Touloupas C, Pouvelle A, et al. Interobserver agreement with MRI vs. CT for pancreatic tumour size measurement before and after neoadjuvant therapy. Eur J Radiol. 2026. PMID: 42008888. doi:10.1016/j.ejrad.2026.112874
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