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Subspecialty Second-Opinion in Multiple Myeloma CT: Emphasis on Clinically Significant Lytic Lesions.
Tagliafico, Alberto Stefano; Belgioia, Liliana; Bonsignore, Alessandro; Rossi, Federica; Succio, Giulia; Bignotti, Bianca; Dominietto, Alida.
Afiliación
  • Tagliafico AS; IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
  • Belgioia L; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
  • Bonsignore A; IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
  • Rossi F; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
  • Succio G; IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
  • Bignotti B; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
  • Dominietto A; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
Medicina (Kaunas) ; 56(4)2020 Apr 23.
Article en En | MEDLINE | ID: mdl-32340143
Background and objectives: In order to increase the accuracy of lytic lesion detection in multiple myeloma, a dedicated second-opinion interpretation of medical images performed by subspecialty musculoskeletal radiologists could increase accuracy. Therefore, the purpose of this study is to evaluate the added value (increased accuracy) of subspecialty second-opinion (SSO) consultations for Computed Tomography (CT) examinations in Multiple Myeloma (MM) patients undergoing stem cell transplantation on standard computed tomography with a focus on focal lesion detection. Materials and Methods: Approval from the institutional review board was obtained. This retrospective study included 70 MM consecutive patients (mean age, 62 years ± 11.3 (standard deviation); range, 35-88 years) admitted in the last six years. Pre-transplant total-body CT (reported by general radiologists) was the only inclusion criteria. Each of these CT examinations had a second-opinion interpretation by two experienced subspecialty musculoskeletal (MSK) radiologists (13 years of experience and 6 years of experience, mean: 9.5 years), experts in musculoskeletal radiology and bone image interpretation with a focus on lytic lesions. Results: Per lesion intra- and inter-observer agreement between the two radiologists was calculated with K statistics and the results were good (K = 0.67: Confidence Inteval (CI) 95%: 0.61-0.78). When the initial CT reports were compared with the re-interpretation reports, 46 (65%) of the 70 cases (95% CI: 37-75%) had no discrepancy. There was a discrepancy in detecting a clinically unimportant abnormality in 10/70 (14%) patients (95% CI: 7-25%) unlikely to alter patient care or irrelevant to further clinical management. A discrepancy in interpreting a clinically important abnormality was registered in 14/70 (21%) patients for focal lesions. The mean diameter of focal lesions was: 23 mm (95% CI: 5-57 mm). The mean number of focal lesions per patient was 3.4 (95% CI). Conclusions: subspecialty second-opinion consultations in multiple myeloma CT is more accurate to identify lesions, especially lytic lesions, amenable to influence patients' care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Neoplasias Óseas / Mieloma Múltiple Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Neoplasias Óseas / Mieloma Múltiple Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza