Rationale and objectives

To evaluate the interest of a systematic second opinion in quality assessment and FIGO staging in the pretherapeutic imaging work-up.

Materials and methods

A retrospective observational study was conducted on 156 patients who underwent surgery for endometrioid cancer in our institution. 42 % had their initial MRI scans performed in expert centers (University Hospital and Cancer center) and 58 % in non-expert centers. Quality assessment, concordances between initial reports, and second opinions by a junior and a senior ICL radiologist versus histopathological data were analyzed.

Results

MRI scans performed in expert centers were more complete and more likely to be rated as higher quality. The overall accuracy of T staging from initial reports vs gold standard was 0.59 (95 % CI, 0.46–0.71) in expert centers and 0.49 (95 % CI, 0.38–0.60) in non-expert centers. The overall accuracy and Kappa of a second opinion for FIGO 2009 staging from expert center and non-expert center examinations were 0.61 (95 % CI, 0.48–0.72) vs 0.50 (95 % CI, 0.39–0.60) and 0.37 vs 0.27 for junior reader and 0.62 (95 % CI, 0.49–0.74) vs 0.48 (95 % CI, 0.37–0.58) and 0.39 vs 0.24 for senior reader, respectively. There was also a significant lower confidence level of the junior radiologist in MRI FIGO staging for non-expert center examinations (p 0.003).

Conclusion

Accuracy in the FIGO 2009 staging and quality assessment are higher for MR examinations performed from expert centers than in non-expert centers. A systematic second opinion by radiologists in expert centers should be proposed before pre-treatment multidisciplinary consultation.

中文翻译：

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子宫内膜癌分期中治疗前影像检查的评估：对癌症中心系统性第二意见的兴趣

理由和目标

评估系统性第二意见对治疗前影像检查质量评估和 Figo 分期的兴趣。

材料和方法

对我们机构的 156 名接受子宫内膜样癌手术的患者进行了一项回顾性观察研究。42% 的人在专家中心（大学医院和癌症中心）进行了首次 MRI 扫描，58% 的人在非专家中心进行了初次 MRI 扫描。对质量评估、初始报告之间的一致性以及初级和高级 ICL 放射科医生的第二意见与组织病理学数据进行了分析。

结果

在专家中心进行的 MRI 扫描更完整，更有可能被评为更高质量。与金标准相比，初始报告 T 分期的总体准确度在专家中心为 0.59（95% CI，0.46-0.71），在非专家中心为 0.49（95% CI，0.38-0.60）。专家中心和非专家中心检查的FIGO 2009分期第二意见的总体准确性和Kappa分别为0.61 (95% CI, 0.48–0.72) vs 0.50 (95% CI, 0.39–0.60)，初级阶段为0.37 vs 0.27对于高级读者，分别为 0.62 (95% CI, 0.49–0.74) 和 0.48 (95% CI, 0.37–0.58) 和 0.39 vs 0.24。初级放射科医生对非专家中心检查的 MRI FigO 分期的置信度也显着降低 (p < 0.003)。

结论

专家中心进行的 MR 检查的 FIFA 2009 分期和质量评估的准确性高于非专家中心进行的检查。在治疗前进行多学科会诊之前，应由专家中心的放射科医生提出系统的第二意见。