Impact of Acquisition Method and Region of Interest Placement on Inter-observer Agreement and Measurement of Tumor Response to Targeted Therapy Using Dynamic Contrast-Enhanced Ultrasound

Atri, Mostafa; Hudson, John M.; Sinaei, Mehrdad; Williams, Ronald J.; Milot, Laurent; Moshonov, Hadas; Burns, Peter N.; Bjarnason, Georg A.

doi:10.1016/j.ultrasmedbio.2015.11.005

Cited by 13 publications

(14 citation statements)

References 23 publications

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“…The interobserver agreement of the bolus-and-burst method in our study is comparable to that of the burst replenishment technique as applied by Atri et al [20]. They investigated tumors with variable vascularity, testing different approaches and measured ICC for blood volume estimates between 0.78 and 0.97.…”

Section: Discussionsupporting

confidence: 82%

Interobserver Variation of the Bolus-and-Burst Method for Pancreatic Perfusion with Dynamic – Contrast-Enhanced Ultrasound

Stangeland

Engjom

Mézl

et al. 2017

Ultrasound Int Open

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AbSTR Ac TPurpose Dynamic contrast-enhanced ultrasound (DCE-US) can be used for calculating organ perfusion. By combining bolus injection with burst replenishment, the actual mean transit time (MTT) can be estimated. Blood volume (BV) can be obtained by scaling the data to a vessel on the imaging plane. The study aim was to test interobserver agreement for repeated recordings using the same ultrasound scanner and agreement between results on two different scanner systems. Materials and MethodsTen patients under evaluation for exocrine pancreatic failure were included. Each patient was scanned two times on a GE Logiq E9 scanner, by two different observers, and once on a Philips IU22 scanner, after a bolus of 1.5 ml Sonovue. A 60-second recording of contrast enhancement was performed before the burst and the scan continued for another 30 s for reperfusion. We performed data analysis using MATLAB-based DCE-US software. An artery in the same depth as the region of interest (ROI) was used for scaling. The measurements were compared using the intraclass correlation coefficient (ICC) and Bland Altman plots.Results The interobserver agreement on the Logiq E9 for MTT (ICC = 0.83, confidence interval (CI) 0.46-0.96) was excellent. There was poor agreement for MTT between the Logiq E9 and the IU22 (ICC = − 0.084, CI − 0.68-0.58). The interobserver agreement for blood volume measurements was excellent on the Logiq E9 (ICC = 0.9286,) and between scanners (ICC = 0.86, CI = 0.50-0.97).Conclusion Interobserver agreement was excellent using the same scanner for both parameters and between scanners for BV, but the comparison between two scanners did not yield acceptable agreement for MTT. This was probably due to incomplete bursting of bubbles in some of the recordings on the IU22.

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Section: Discussionsupporting

confidence: 82%

Interobserver Variation of the Bolus-and-Burst Method for Pancreatic Perfusion with Dynamic – Contrast-Enhanced Ultrasound

Stangeland

Engjom

Mézl

et al. 2017

Ultrasound Int Open

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“…Placement of the ROI in CEUS studies is important for quantitative TIC analysis [9,17,29]. Breast cancer is notoriously heterogeneous in genotype, morphology, and vascularization [19], which is a challenge when attempting to achieve standardized ROI determinations.…”

Section: Discussionmentioning

confidence: 99%

“…The quantitative TIC parameters (▶ Fig. 1) were investigated according to the ROI as: (1) peak enhancement (au), defined as the maximum intensity of the curve; (2) wash-in area under the curve (WiAUC, au); (3) wash-out area under the curve (WoAUC, au); (4) wash-in and wash-out areas under the curve (WiWoAUC, au); (5) wash-in rate (WiR, maximum slope, au); (6) wash-out rate (WoR, minimum slope, au); (7) rise time (s); (8) fall time (s); (9) mean transit time local (mTTl, s); (10) time to peak (TTP, s); (11) wash-in perfusion index (WiAUC/rise time); (12) ROI area (cm 2 ); and (13) quality of fit between the echo-power signal and f (t) (%).…”

Section: Methodsmentioning

confidence: 99%

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Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

et al. 2018

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“…Contrast-enhanced ultrasound (CEUS) is of interest because of its ability to glean macrovascular and microvascular information about organs and to aid our understanding of the complexity of angiogenesis in different types of tumors [9][10][11][12][13]. CEUS is a quantitative kinetic imaging modality that assesses intravascular blood flow in breast tumors even at the capillary level [14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

Lee

Kim

Kang

et al. 2019

Senologie - Zeitschrift für Mammadiagnostik und -therapie

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Purpose To evaluate the time-intensity curve (TIC) parameters on contrast-enhanced ultrasound (CEUS) for early prediction of the response of breast cancer to neoadjuvant chemotherapy (NAC). Materials and Methods This prospective study included 41 patients with breast cancer. CEUS was performed before and after the first cycle of NAC. TIC parameters were analyzed for different regions of interest (ROIs). ROI 1 targeted the hotspot area of greatest enhancement, ROI 2 delineated the area of hyperenhancement, ROI 3 included the entire tumor on grayscale ultrasound, and ROI 4 encircled the normal parenchyma. The TIC perfusion values for ROI 1, 2, and 3 were divided by the ROI 4 value. Results 11 (26.8 %) of the 41 patients showed a good response (Miller-Payne score 4 or 5) and 30 (73.2 %) showed a minor response (Miller-Payne score 1, 2, or 3). There were significant differences in the wash-out area under the curve, the wash-in and wash-out areas under the curve on ROI 1/4 after the first cycle of NAC, pre-NAC mean transit time local (mTTl) on ROI 2/4, and pre-NAC mTTl on ROI 3/4 between good and minor responders (area under the receiver-operating characteristic curve > 0.70, p < 0.05). Conclusion Some TIC parameters obtained by CEUS may allow prediction of the response of breast cancer to NAC at a very early time point.

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Impact of Acquisition Method and Region of Interest Placement on Inter-observer Agreement and Measurement of Tumor Response to Targeted Therapy Using Dynamic Contrast-Enhanced Ultrasound

Cited by 13 publications

References 23 publications

Interobserver Variation of the Bolus-and-Burst Method for Pancreatic Perfusion with Dynamic – Contrast-Enhanced Ultrasound

Interobserver Variation of the Bolus-and-Burst Method for Pancreatic Perfusion with Dynamic – Contrast-Enhanced Ultrasound

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

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