Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients

Faizah Mohd Zaki, Rahim Moineddin, Ronald Grant, Govind B. Chavhan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging. Objective: To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients. Materials and methods: We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard. Results: The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P <0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12). Conclusion: Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalPediatric Radiology
DOIs
Publication statusAccepted/In press - 12 Jul 2016

Fingerprint

Magnetic Resonance Imaging
Pediatrics
Gadolinium
Contrast Media
Safety
Neoplasms

Keywords

  • Abdomen
  • Children
  • Contrast medium
  • Gadolinium
  • Magnetic resonance imaging
  • Oncology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health

Cite this

Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients. / Mohd Zaki, Faizah; Moineddin, Rahim; Grant, Ronald; Chavhan, Govind B.

In: Pediatric Radiology, 12.07.2016, p. 1-10.

Research output: Contribution to journalArticle

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title = "Accuracy of pre-contrast imaging in abdominal magnetic resonance imaging of pediatric oncology patients",
abstract = "Background: Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging. Objective: To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients. Materials and methods: We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard. Results: The overall sensitivity was 88{\%} for the first reader and 90{\%} for the second; specificity was 94{\%} and 91{\%}; positive predictive value was 96{\%} and 94{\%}; negative predictive value was 82{\%} and 84{\%}; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90{\%} for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P <0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12). Conclusion: Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor.",
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N2 - Background: Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging. Objective: To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients. Materials and methods: We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard. Results: The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P <0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12). Conclusion: Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor.

AB - Background: Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging. Objective: To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients. Materials and methods: We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard. Results: The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P <0.0001), but the interobserver agreement for the change in confidence was poor (kappa 0.12). Conclusion: Pre-contrast abdominal MR imaging has high accuracy in lesion detection in pediatric oncology patients and shows substantial agreement with the reference standard for characterization of lesions. Gadolinium-based contrast media administration cannot be completely eliminated but can be avoided in many cases, with the decision made on a case-by-case basis, taking into consideration location and type of tumor.

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KW - Magnetic resonance imaging

KW - Oncology

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