使用腹膜癌指数预测在大叶伏安癌症患者中的非可察觉性 - 使用成像的前瞻性多中心研究（ISAAC研究）
Prediction of non-resectability in tubo-ovarian cancer patients using Peritoneal Cancer Index - A prospective multicentric study using imaging (ISAAC study)
影响因子:4.10000
分区:医学2区 Top / 妇产科学1区 肿瘤学2区
发表日期:2024 Dec
作者:
Patrícia Pinto, Francesca Moro, Juan Luis Alcázar, Sarah Alessi, Giacomo Avesani, Klára Benesova, Andrea Burgetova, Giuseppina Calareso, Valentina Chiappa, David Cibula, Anna Fagotti, Dorella Franchi, Filip Frühauf, Jiri Jarkovsky, Roman Kocian, Lukas Lambert, Martin Masek, Camilla Panico, Paola Pricolo, Giovanni Scambia, Jiri Slama, Antonia Carla Testa, Ailyn Mariela Vidal Urbinati, Julio Vara Garcia, Raffaella Vigorito, Daniela Fischerová
摘要
目的是使用成像（超声，对比增强的计算机断层扫描（CT）和全身扩散加权磁共振成像（WB-DWI/MRI）评估腹膜癌癌和预测非可分离性carciNOMARIS carciNARINE carcINARITY。我们认为，所有可疑的卵巢/输卵管/腹膜癌的患者都接受了术前超声，CT和WB-DWI/MRI（如果有的话） > 1厘米或手术在评估PCI评分中包括的位点的成像方法和手术探索之间不可行。 > 10且AUC为0.81，WB-DWI/MRI的截止时间> 12，AUC为0.81，使用ICC的临界值为> 11，AUC为0.74。与WB-DWI/MRI和CT相比，在评估放射线PCI方面，超声是CT，而其对WB-DWI/MRI的不介绍。
Abstract
The aim was to evaluate the performance of the Peritoneal Cancer Index (PCI) using imaging (ultrasound, contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) in assessing peritoneal carcinomatosis and predicting non-resectability in tubo-ovarian carcinoma patients.This was a prospective multicenter observational study. We considered all patients with suspected primary ovarian/tubal/peritoneal cancer who underwent preoperative ultrasound, CT, and WB-DWI/MRI (if available). The optimal cut off value for assessing the performance of the methods in predicting non-resectability was identified at the point at which the sensitivity and specificity were most similar. The reference standard to predict non-resectability was surgical outcome in terms of residual disease >1 cm or surgery not feasible. Agreement between imaging methods and surgical exploration in assessing sites included in the PCI score was evaluated using the Intraclass Correlation Coefficient (ICC).242 patients were included from January 2020 until November 2022. The optimal PCI cut-off for predicting non-resectability for surgical exploration was >12, which achieved the best AUC of 0.87, followed by ultrasound with a cut-off of >10 and AUC of 0.81, WB-DWI/MRI with a cut-off of >12 and AUC of 0.81, and CT with a cut-off of >11 and AUC of 0.74. Using ICC, ultrasound had very high agreement (0.94) with surgical PCI, while CT and WB-DWI/MRI had high agreement (0.86 and 0.87, respectively).Ultrasound performed by an expert operator had the best agreement with surgical findings compared to WB-DWI/MRI and CT in assessing radiological PCI. In predicting non-resectability, ultrasound was non-inferior to CT, while its non-inferiority to WB-DWI/MRI was not demonstrated.