Diffusion‐weighted quantitative MRI of pleural abnormalities: Intra‐ and interobserver variability in the apparent diffusion coefficient measurements

Priola, Adriano Massimiliano; Priola, Sandro Massimo; Gned, Dario; Giraudo, Marı́a Teresa; Brundu, Maria; Righi, Luisella; Veltri, Andrea

doi:10.1002/jmri.25633

Cited by 10 publications

(10 citation statements)

References 44 publications

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“…Indeed, the whole tumour volume method of ADC measurement was found the most repeatable, suggesting that inclusion of the entire tumour volume leads to a decrease in inter-observer variation because this method, unlike other methods, does not require the reader to select the slice or the area with the lowest signal on the ADC map ( 20 ). Similar results were found for other tumours including pleural abnormalities, rectal cancer, endometrial cancer, and musculoskeletal lesions ( 4 , 17 , 21 ).…”

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confidence: 85%

Importance of measurement repeatability of semi-quantitative imaging through PET-CT and PET-MR imaging in oncology

Priola

2019

Transl. Cancer Res.

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supporting

confidence: 85%

Importance of measurement repeatability of semi-quantitative imaging through PET-CT and PET-MR imaging in oncology

Priola

2019

Transl. Cancer Res.

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“…The first step is to determine the tumor-containing slice or slices, comprising single-slice (SS) selection, selection of three predefined slices (PD), observer-based (OB) volume, 110 or whole tumor volume (WTV). 111 The WTV method has the best repeatability and interobserver consistency, while the selective OB and SS methods can well approximate the WTV measurement and require significantly less measurement times, facilitating their adoption in a clinical setting. 110,111 The second step involves determination of ROI contours encasing tumor areas within the chosen slice(s).…”

Section: Roi Selection For Quantitative Assessmentmentioning

confidence: 99%

“…111 The WTV method has the best repeatability and interobserver consistency, while the selective OB and SS methods can well approximate the WTV measurement and require significantly less measurement times, facilitating their adoption in a clinical setting. 110,111 The second step involves determination of ROI contours encasing tumor areas within the chosen slice(s). The contour selection should reflect the specific study purpose.…”

Section: Roi Selection For Quantitative Assessmentmentioning

confidence: 99%

Diffusion MRI of cancer: From low to high b‐values

Tang

Zhou

2018

Magnetic Resonance Imaging

163

112

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Following its success in early detection of cerebral ischemia, diffusion-weighted imaging (DWI) has been increasingly used in cancer diagnosis and treatment evaluation. These applications are propelled by the rapid development of novel diffusion models to extract biologically valuable information from diffusion-weighted MR signals, and significant advance in MR hardware that has enabled image acquisition with high b-values. This article reviews recent technical developments and clinical applications in cancer imaging using DWI, with a special emphasis on high b-value diffusion models. The article is organized in four sections. First, we provide an overview of diffusion models that are relevant to cancer imaging. The model parameters are discussed in relation to three tissue properties – cellularly, vascularity, and microstructures. An emphasis is placed on characterization of microstructural heterogeneity, given its novelty and close relevance to cancer. Second, we illustrate diffusion MR clinical applications in each of the following three categories: (a) cancer detection and diagnosis; (b) cancer grading, staging, and classification; and (c) cancer treatment response prediction and evaluation. Third, we discuss several practical issues, including selection of image acquisition parameters, reproducibility and reliability, motion management, image distortion, etc., that are commonly encountered when applying DWI to cancer in clinical settings. Lastly, we highlight a few ongoing challenges and provide some possible future directions, particularly in the area of establishing standards via well-organized multi-center clinical trials to accelerate clinical translation of advanced DWI techniques to improving cancer care on a large scale.

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“…However, the measurement agreement for DW-MRE quantitative parameters has not been ascertained to date[8]. To facilitate the application of quantitative DW-MRE into the clinical routine, a thorough study of the intra and interobserver reproducibility of DWI quantitative parameters should be performed, similar to what has been done in other organs[19,20].…”

Section: Discussionmentioning

confidence: 99%

“…And systematic investigations on measurement reproducibility of quantitative DWI analysis in MRE have not been ascertained so far. The characterization of reader agreement and variability with quantitative parameters is imperative before such parameters are to be incorporated into clinical practice[19-21]. As ADC values could be affected by the image mismatch calculated from DWI with at least two b values[5,8], we proposed an abbreviated proxy for diffusion restriction, a signal intensity ratio (SR), between the terminal ileum and ipsilateral psoas muscle on DWI with an appropriate b value (800 s/mm 2 ), and explored the application of SR and ADC values in CD patients.…”

Section: Introductionmentioning

confidence: 99%

Quantitative diffusion-weighted magnetic resonance enterography in ileal Crohn's disease: A systematic analysis of intra and interobserver reproducibility

Shen

Tan

et al. 2019

WJG

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BACKGROUND Magnetic resonance enterography (MRE) is increasingly attractive as a noninvasive and radiation-free tool for assessing Crohn’s disease (CD). Diffusion-weighted imaging (DWI) is recommended as an optional MRE sequence for CD by the European Society of Gastrointestinal and Abdominal Radiology, and has shown a superb potential as a quantitative modality for bowel inflammation evaluation. However, the measurement reproducibility of quantitative DWI analysis in MRE has not been ascertained so far. To facilitate the application of quantitative diffusion-weighted MRE in the clinical routine, systematic investigations of the intra and interobserver reproducibility of DWI quantitative parameters should be performed. AIM To evaluate the intra and interobserver reproducibility of quantitative analysis for diffusion-weighted MRE (DW-MRE) in ileal CD. METHODS Forty-four subjects (21 with CD and 23 control subjects) who underwent ileocolonoscopy and DW-MRE (b = 800 s/mm 2 ) within one week were included. Two radiologists independently measured apparent diffusion coefficients (ADC) of the terminal ileum and signal intensity ratio (SR) of the terminal ileum to ipsilateral psoas muscle on DWI images (b = 800 s/mm 2 ). Between- and within-reader agreements were assessed using intraclass correlation coefficients (ICC), coefficients of variation (CoV), and 95% limits of agreement of Bland-Altman plots (BA-LA LoA). Diagnostic performances of ADC and SR for identifying inflamed terminal ileum from the normal were evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS There were no significant differences in ADC or SR values between the two sessions or between the two radiologists either in the CD or control group (paired t -test, P > 0.05). The intra and interobserver reproducibility of ADC (ICC: 0.952-0.984; CoV: 3.73-6.28%; BA-LA LoA: ±11.27% to ±15.88%) and SR (ICC: 0.969-0.989; CoV: 3.51%-4.64%; BA-LA LoA: ±10.62% to ±15.45%) was excellent for CD. Agreement of ADC measurements was slightly less in control subjects (ICC: 0.641-0.736; CoV: 10.47%-11.43%; BA-LA LoA: ± 26.59% to ± 30.83%). SR of normal terminal ileum demonstrated high intra and interobserver reproducibility (ICC: 0.944-0.974; CoV: 3.73%-6.28%; BA-LA LoA: ± 18.58% to ± 24.43%). ADC and SR of two readers had outstanding diagnostic efficiencies (area under the ROC curve: 0.923-0.988). CONCLUSION Quantitative parameters derived from DW-MRE have good to excellent intra and interobserver agreements with high diagnostic accuracy, and can serve as robust and efficient quantitative biomarkers for CD evaluation.

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Diffusion‐weighted quantitative MRI of pleural abnormalities: Intra‐ and interobserver variability in the apparent diffusion coefficient measurements

Abstract: 4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:769-782.

Cited by 10 publications

References 44 publications

Importance of measurement repeatability of semi-quantitative imaging through PET-CT and PET-MR imaging in oncology

Importance of measurement repeatability of semi-quantitative imaging through PET-CT and PET-MR imaging in oncology

Diffusion MRI of cancer: From low to high b‐values

Quantitative diffusion-weighted magnetic resonance enterography in ileal Crohn's disease: A systematic analysis of intra and interobserver reproducibility

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