BT-RADS is a new framework system for reporting the treatment response of brain tumors. The aim of the study was to assess the diagnostic performance and reliability of the BT-RADS in predicting the recurrence of high-grade glioma (HGG). This prospective single-center study recruited 81 cases with previously operated and pathologically proven HGG. The patients underwent baseline and follow-up contrast-enhanced MRI (CE-MRI). Two neuro-radiologists with ten years-experience in neuroimaging independently analyzed and interpreted the MRI images and assigned a BT-RADS category for each case. To assess the diagnostic accuracy of the BT-RADS for detecting recurrent HGG, the reference standard was the histopathology for BT-RADS categories 3 and 4, while neurological clinical examination and clinical follow up were used as a reference for BT-RADS categories 1 and 2. The inter-reader agreement was assessed using the Cohen's Kappa test. The study included 81 cases of HGG, of which 42 were recurrent and 39 were non-recurrent HGG cases based on the reference test. BT-RADS 3B was the best cutoff for predicting recurrent HGG with a sensitivity of 90.5 % to 92.9 %, specificity of 76.9 % to 84.6 %, and accuracy of 83.9 % to 88.9 %, based on both readers. The BT-RADS showed a substantial inter-reader agreement with a of 0.710 (). The BT-RADS is a valid and reliable framework for predicting recurrent HGG. Moreover, BT-RADS can help neuro-oncologists make clinical decisions that can potentially improve the patient's outcome.

中文翻译：

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BT-RADS 在复发性高级别胶质瘤治疗中的诊断有效性和可靠性

BT-RADS 是一个用于报告脑肿瘤治疗反应的新框架系统。该研究的目的是评估 BT-RADS 在预测高级别胶质瘤 (HGG) 复发方面的诊断性能和可靠性。这项前瞻性单中心研究招募了 81 例既往接受过手术且经病理证实的 HGG 病例。患者接受了基线和随访对比增强 MRI (CE-MRI)。两名拥有十年神经影像经验的神经放射科医生独立分析和解释 MRI 图像，并为每个病例分配 BT-RADS 类别。为了评估 BT-RADS 对复发性 HGG 的诊断准确性，BT-RADS 3 类和 4 类的参考标准是组织病理学，而 BT-RADS 1 类和 4 类的参考标准是神经临床检查和临床随访。 2. 使用 Cohen's Kappa 检验评估读者间的一致性。该研究纳入了 81 例 HGG 病例，根据参考测试，其中 42 例为复发性 HGG 病例，39 例为非复发性 HGG 病例。根据两位读者的数据，BT-RADS 3B 是预测复发性 HGG 的最佳截止值，其敏感性为 90.5% 至 92.9%，特异性为 76.9% 至 84.6%，准确性为 83.9% 至 88.9%。 BT-RADS 显示出显着的读者间一致性，值为 0.710 ()。 BT-RADS 是预测复发性 HGG 的有效且可靠的框架。此外，BT-RADS 可以帮助神经肿瘤学家做出临床决策，从而有可能改善患者的治疗结果。