دورية أكاديمية
Causes of missed MRI diagnosis of radiotherapy-induced temporal lobe injury in nasopharyngeal carcinoma.
| العنوان: | Causes of missed MRI diagnosis of radiotherapy-induced temporal lobe injury in nasopharyngeal carcinoma. |
|---|---|
| عنوان ترانسليتريتد: | MRI检查鼻咽癌放射性颞叶损伤的漏诊原因. |
| المؤلفون: | Chen R; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008. chenruiting1010@163.com., Zhao L; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008., Yang F; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008., Zhou G; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008., Wang D; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008., Zhao Q; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008. 570153364@qq.com.; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008, China. 570153364@qq.com., Liao W; Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008.; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008, China. |
| المصدر: | Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences [Zhong Nan Da Xue Xue Bao Yi Xue Ban] 2024 May 28; Vol. 49 (5), pp. 698-704. |
| نوع المنشور: | Journal Article |
| اللغة: | English; Chinese |
| بيانات الدورية: | Publisher: |
| أسماء مطبوعة: | Original Publication: Changsha Shi : "Zhong nan da xue xue bao (yi xue ban)" bian ji bu, 2004- |
| مواضيع طبية MeSH: | Magnetic Resonance Imaging*/methods , Nasopharyngeal Carcinoma*/radiotherapy , Nasopharyngeal Carcinoma*/diagnostic imaging , Temporal Lobe*/diagnostic imaging , Temporal Lobe*/radiation effects , Nasopharyngeal Neoplasms*/radiotherapy , Nasopharyngeal Neoplasms*/diagnostic imaging, Humans ; Radiation Injuries/etiology ; Radiation Injuries/diagnostic imaging ; Missed Diagnosis ; Risk Factors ; Male ; Female ; Middle Aged |
| مستخلص: | Objectives: Radiotherapy is the primary treatment for nasopharyngeal carcinoma, but it frequently leads to radiotherapy-induced temporal lobe injury (RTLI). Magnetic resonance imaging (MRI) is the main diagnostic method for RTLI after radiotherapy for nasopharyngeal carcinoma, but it is prone to missed diagnoses. This study aims to investigate the causes of missed diagnoses of RTLI in nasopharyngeal carcinoma patients undergoing MRI after radiotherapy. Methods: Clinical and MRI data from nasopharyngeal carcinoma patients diagnosed and treated with radiotherapy at Xiangya Hospital of Central South University, from January 2010 to April 2021, were collected. Two radiologists reviewed all head and neck MRIs (including nasopharyngeal and brain MRIs) before and after radiotherapy of identify cases of late delayed response-type RTLI for the first time. If the original diagnosis of the initial RTLI in nasopharyngeal carcinoma patients did not report temporal lobe lesions, it was defined as a missed diagnosis. The first diagnosis of RTLI cases was divided into a missed diagnosis group and a non-missed diagnosis group. Clinical and imaging data were compared between the 2 groups, and multivariate logistic regression analysis was used to identify independent risk factors for MRI missed diagnoses of initial RTLI. Results: A total of 187 nasopharyngeal carcinoma with post-radiotherapy RTLI were included. The original diagnostic reports missed 120 cases and accurately diagnosed 67 cases, with an initial RTLI diagnosis accuracy rate of 35.8% and a missed diagnosis rate of 64.2%. There were statistically significant differences between the missed diagnosis group and the non-missed diagnosis group in terms of lesion size, location, presence of contralateral temporal lobe lesions, white matter high signal, cystic degeneration, hemorrhage, fluid attenuated inversion recovery (FLAIR), and examination site (all P <0.05). Multivariate logistic regression analysis showed that lesions ≤25 mm, non-enhancing lesions, lesions without cystic degeneration or hemorrhage, lesions located only in the medial temporal lobe, and MRI examination only of the nasopharynx were independent risk factors for missed MRI diagnosis of initial RTLI (all P <0.05). Conclusions: The missed diagnosis of initial RTLI on MRI is mainly related to lesion size and location, imaging characteristics, and MRI examination site. |
| References: | Lancet. 2019 Jul 6;394(10192):64-80. (PMID: 31178151) Radiology. 1999 Dec;213(3):800-7. (PMID: 10580956) Sci Rep. 2018 Apr 4;8(1):5595. (PMID: 29618828) Biochimie. 2003 Sep;85(9):905-14. (PMID: 14652179) Clin Radiol. 2012 Apr;67(4):340-5. (PMID: 22119296) Int J Radiat Oncol Biol Phys. 2017 Feb 1;97(2):263-269. (PMID: 28068234) Eur Radiol. 2001;11(2):317-24. (PMID: 11218034) J Neuroradiol. 2014 Mar;41(1):52-70. (PMID: 24439107) Radiat Oncol. 2020 May 15;15(1):112. (PMID: 32414378) Radiology. 2010 Jan;254(1):210-8. (PMID: 20019142) |
| فهرسة مساهمة: | Keywords: magnetic resonance imaging; missed diagnosis; nasopharyngeal carcinoma; radiotherapy-induced temporal lobe injury Local Abstract: [Publisher, Chinese] 目的 : 放射治疗是鼻咽癌的主要治疗方法，但容易发生放射性颞叶损伤(radiotherapy-induced temporal lobe injury，RTLI)。磁共振成像(magnetic resonance imaging，MRI)检查是鼻咽癌放射治疗后RTLI的主要诊断方法，但容易漏诊。本研究旨在探讨MRI检查鼻咽癌放射治疗后RTLI漏诊的原因。 方法 : 回顾性分析2010年1月至2021年4月在中南大学湘雅医院诊断为鼻咽癌且接受放射治疗患者的临床和MRI资料。由2位放射科医生重新审阅患者放射治疗前、后所有头颈部(包括鼻咽部和颅脑)MRI资料，对首次发现颞叶晚迟发反应型放射性脑损伤的患者作出首次RTLI诊断。若首次诊断鼻咽癌RTLI患者的原始诊断未报告颞叶病变，则定义为漏诊。将首次诊断鼻咽癌RTLI患者分为漏诊组和非漏诊组。比较漏诊组与非漏诊组的一般临床资料和影像学资料，并进一步采用多因素Logistic回归分析MRI漏诊首次RTLI的独立危险因素。 结果 : 共纳入符合要求的鼻咽癌放射治疗后首次诊断为RTLI的患者187例，原始诊断报告漏诊120例，未漏诊67例，首次诊断RTLI的准确率为35.8%，漏诊率为64.2%。漏诊组与未漏诊组在病灶大小、病灶是否仅在内侧颞叶、对侧颞叶有无病灶、有无白质高信号/囊变及出血、MRI检查部位以及有无水抑制反转恢复序列(fluid attenuated inversion recovery，FLAIR)序列方面的差异均有统计学意义(均 P <0.05)。多因素Logistic回归分析显示：病灶≤25 mm、病灶无强化、病灶无囊变及出血、病灶仅在内侧颞叶和仅检查鼻咽部MRI是MRI漏诊首次RTLI的独立危险因素(均 P <0.05)。 结论 : MRI首次诊断RTLI的漏诊主要与病灶的大小和部位、病灶的影像学特点及MRI检查部位相关。. |
| تواريخ الأحداث: | Date Created: 20240822 Date Completed: 20240823 Latest Revision: 20240825 |
| رمز التحديث: | 20240826 |
| مُعرف محوري في PubMed: | PMC11341227 |
| DOI: | 10.11817/j.issn.1672-7347.2024.230574 |
| PMID: | 39174883 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1672-7347 |
|---|---|
| DOI: | 10.11817/j.issn.1672-7347.2024.230574 |