Journal Article

Validating Brain Tumor Reporting and Data System (BT-RADS) as a Diagnostic Tool for Glioma Follow-Up after Surgery

Zeed, Nesma Adel, Metwally, Maha Ibrahim, Balata, Rawda, Al Attar, Ahmed Z., Aly, Sameh Abdelaziz, Nada, Mohamad Gamal, Hamed, Enas Mahmoud, Basha, Mohammad Abd Alkhalik, Morsy, Ahmed A., Basha, Ahmed M. Abdelkhalik, Alduraibi, Sharifa Khalid, Farag, Mohamed Abd El-Aziz Mohamed, Amer, Mona M., Almalki, Yassir Edrees

2024

Overview

Gliomas are a type of brain tumor that requires accurate monitoring for progression following surgery. The Brain Tumor Reporting and Data System (BT-RADS) has emerged as a potential tool for improving diagnostic accuracy and reducing the need for repeated operations. This prospective multicenter study aimed to evaluate the diagnostic accuracy and reliability of BT-RADS in predicting tumor progression (TP) in postoperative glioma patients and evaluate its acceptance in clinical practice. The study enrolled patients with a history of partial or complete resection of high-grade glioma. All patients underwent two consecutive follow-up brain MRI examinations. Five neuroradiologists independently evaluated the MRI examinations using the BT-RADS. The diagnostic accuracy of the BT-RADS for predicting TP was calculated using histopathology after reoperation and clinical and imaging follow-up as reference standards. Reliability based on inter-reader agreement (IRA) was assessed using kappa statistics. Reader acceptance was evaluated using a short survey. The final analysis included 73 patients (male, 67.1%; female, 32.9%; mean age, 43.2 ± 12.9 years; age range, 31–67 years); 47.9% showed TP, and 52.1% showed no TP. According to readers, TP was observed in 25–41.7% of BT-3a, 61.5–88.9% of BT-3b, 75–90.9% of BT-3c, and 91.7–100% of BT-RADS-4. Considering >BT-RADS-3a as a cutoff value for TP, the sensitivity, specificity, and accuracy of the BT-RADS were 68.6–85.7%, 84.2–92.1%, and 78.1–86.3%, respectively, according to the reader. The overall IRA was good (κ = 0.75) for the final BT-RADS classification and very good for detecting new lesions (κ = 0.89). The readers completely agreed with the statement “the application of the BT-RADS should be encouraged” (score = 25). The BT-RADS has good diagnostic accuracy and reliability for predicting TP in postoperative glioma patients. However, BT-RADS 3 needs further improvements to increase its diagnostic accuracy.

• Publisher: MDPI AG
• Subject: Bandwidths / Biopsy / Brain cancer / Brain tumors / BT-RADS / Development and progression / Diagnosis / follow-up / Glioma / Gliomas / Magnetic resonance imaging / Management decisions / Medical imaging / Medical research / Medicine, Experimental / Neuroimaging / Oncology / Patients / Radiation / Statistical analysis / Surgery / tumor progression / Tumors / Work stations