Interobserver and intraobserver variability of the apparent diffusion coefficient in treated malignant hepatic lesions on a 3.0T machine: Measurements in the whole lesion versus in the area with the most restricted diffusion

Lu, Tri-Linh; Meuli, Reto; Marques‐Vidal, Pedro; Bize, Pierre; Denys, Alban; Schmidt, Sabine

doi:10.1002/jmri.22301

Cited by 16 publications

(12 citation statements)

References 24 publications

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“…Selection of the axial slice and placement of the ROI can influence the obtained result greatly. While a previous study found no correlation between the heterogeneity of the lesion and the interobserver difference of ADC measurements [28], the authors also admitted that interobserver agreement was higher if only the areas of most restricted diffusion were assessed instead of the whole lesion. Since we sought to simulate clinical image interpretation where the radiologist decides the location of the ROI, the observers in our study were instructed to include as much of the tumor as possible into an ROI, but had no additional prior consensus for the placement of ROIs (i.e.…”

Section: Discussionmentioning

confidence: 90%

Interobserver agreement of semi-automated and manual measurements of functional MRI metrics of treatment response in hepatocellular carcinoma

Bonekamp¹,

Bonekamp²,

Halappa³

et al. 2014

European Journal of Radiology

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Purpose To assess the interobserver agreement in 50 patients with hepatocellular carcinoma (HCC) before and 1 month after intra-arterial therapy (IAT) using two semi-automated methods and a manual approach for the following functional, volumetric and morphologic parameters: (1) apparent diffusion coefficient (ADC), (2) arterial phase enhancement (AE), (3) portal venous phase enhancement (VE), (4) tumor volume, and assessment according to (5) the Response Evaluation Criteria in Solid Tumors (RECIST), and (6) the European Association for the Study of the Liver (EASL). Materials and methods This HIPAA-compliant retrospective study had institutional review board approval. The requirement for patient informed consent was waived. Tumor ADC, AE, VE, volume, RECIST, and EASL in 50 index lesions was measured by three observers. Interobserver reproducibility was evaluated using intraclass correlation coefficients (ICC). P < 0.05 was considered to indicate a significant difference. Results Semi-automated volumetric measurements of functional parameters (ADC, AE, and VE) before and after IAT as well as change in tumor ADC, AE, or VE had better interobserver agreement (ICC = 0.830–0.974) compared with manual ROI-based axial measurements (ICC = 0.157–0.799). Semi-automated measurements of tumor volume and size in the axial plane before and after IAT had better interobserver agreement (ICC = 0.854–0.996) compared with manual size measurements (ICC = 0.543–0.596), and interobserver agreement for change in tumor RECIST size was also higher using semi-automated measurements (ICC = 0.655) compared with manual measurements (ICC = 0.169). EASL measurements of tumor enhancement in the axial plane before and after IAT ((ICC = 0.758–0.809), and changes in EASL after IAT (ICC = 0.653) had good interobserver agreement. Conclusion Semi-automated measurements of functional changes assessed by ADC and VE based on whole-lesion segmentation demonstrated better reproducibility than ROI-based axial measurements, or RECIST or EASL measurements.

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Section: Discussionmentioning

confidence: 90%

Interobserver agreement of semi-automated and manual measurements of functional MRI metrics of treatment response in hepatocellular carcinoma

Bonekamp¹,

Bonekamp²,

Halappa³

et al. 2014

European Journal of Radiology

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“…Future studies should compare DWI findings, conventional imaging findings, and a combination of the two. Third, not only was our study performed with single‐reader observations, but there is no standard for ADC measurements, the reproducibility of ADC measurements is still being investigated,35‐39 and the reproducibility of our results requires external validation. In addition, our study was conducted with a 3.0‐T system.…”

Section: Discussionmentioning

confidence: 99%

Preoperative prediction of the microvascular invasion of hepatocellular carcinoma with diffusion-weighted imaging

et al. 2012

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The aim of this study was to investigate whether diffusion-weighted imaging (DWI) could be useful in predicting the microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Sixty-seven surgically proven HCCs from 65 patients (54 men and 11 women with an age range of 35-75 years and a mean age of 56.0 years) were retrospectively analyzed. The signal intensities (SIs) of the lesions on preoperative diffusion-weighted (DW) images were visually categorized as isointense or hyperintense in comparison with the adjacent liver. We also quantitatively measured SIs and apparent diffusion coefficients (ADCs) by drawing regions of interest in HCCs and livers on DW images with b values of 50, 400, and 800 second/mm 2 and on ADC map images. Logistic regression analyses were performed so that we could identify independent predictors of MVI among laboratory and DWI findings. A univariate analysis showed that a histological grade of 3, a larger tumor size, a higher SI ratio on DW images, and a lower ADC value were significantly associated with MVI. A multiple logistic regression analysis showed that a histological grade of 3 and the ADC value were independent predictors of MVI. With a cutoff of 1.11 Â 10 À3 mm 2 /second, the ADC value provided a sensitivity of 93.5% and a specificity of 72.2% for the prediction of MVI with an odds ratio of 24.5 (95% confidence interval ¼ 4.14-144.8, P < 0.001). In conclusion, lower ADC values (1.11 Â 10 À3 mm 2 /second or less) can be a useful predictor of MVI during the preoperative evaluation of HCC.

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“…Moreover, previous work has shown that volumetric analysis of quantitative derived parameters is more repeatable than single-slice region of interest-based quantification. 19 …”

Section: Discussionmentioning

confidence: 99%

Evolution of multi-parametric MRI quantitative parameters following transrectal ultrasound-guided biopsy of the prostate

Latifoltojar

Δικαίος

Ridout

et al. 2015

Prostate Cancer Prostatic Dis

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Background:To determine the evolution of prostatic multi-parametric magnetic resonance imaging (mp-MRI) signal following transrectal ultrasound (TRUS)-guided biopsy.Methods:Local ethical permission and informed written consent was obtained from all the participants (n=14, aged 43–69, mean 64 years). Patients with a clinical suspicion of prostate cancer (PSA range 2.2–11.7, mean 6.2) and a negative (PIRAD 1–2/5) pre-biopsy mp-MRI (pre-contrast T1, T2, diffusion-weighted and dynamic-contrast-enhanced MRI) who underwent 10-core TRUS-guided biopsy were recruited for additional mp-MRI examinations performed at 1, 2 and 6 months post biopsy. We quantified mp-MRI peripheral zone (PZ) and transition zone (TZ) normalized T2 signal intensity (nT2-SI); T1 relaxation time (T10); diffusion-weighted MRI, apparent diffusion coefficient (ADC); dynamic contrast-enhanced MRI, maximum enhancement (ME); slope of enhancement (SoE) and area-under-the-contrast-enhancement-curve at 120 s (AUC120). Significant changes in mp-MRI parameters were identified by analysis of variance with Dunnett's post testing.Results:Diffuse signal changes were observed post-biopsy throughout the PZ. No significant signal change occurred following biopsy within the TZ. Left and right PZ mean nT2-SI (left PZ: 5.73, 5.16, 4.90 and 5.12; right PZ: 5.80, 5.10, 4.84 and 5.05 at pre-biopsy, 1, 2 and 6 months post biopsy, respectively) and mean T10 (left PZ: 1.02, 0.67, 0.78, 0.85; right PZ: 1.29, 0.64, 0.78, 0.87 at pre-biopsy, 1, 2 and 6 months post biopsy, respectively) were reduced significantly (P<0.05) from pre-biopsy values for up to 6 months post biopsy. Significant changes (P<0.05) of PZ-ME and AUC120 were observed at 1 month but resolved by 2 months post biopsy. PZ ADC did not change significantly following biopsy (P=0.23–1.0). There was no significant change of any TZ mp-MRI parameter at any time point following biopsy (P=0.1–1.0).Conclusions:Significant PZ (but not TZ) T2 signal changes persist up to 6 months post biopsy, whereas PZ and TZ ADC is not significantly altered as early as 1 month post biopsy. Caution must be exercised when interpreting T1- and T2-weighted imaging early post biopsy, whereas ADC images are more likely to maintain clinical efficacy.

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Interobserver and intraobserver variability of the apparent diffusion coefficient in treated malignant hepatic lesions on a 3.0T machine: Measurements in the whole lesion versus in the area with the most restricted diffusion

Cited by 16 publications

References 24 publications

Interobserver agreement of semi-automated and manual measurements of functional MRI metrics of treatment response in hepatocellular carcinoma

Interobserver agreement of semi-automated and manual measurements of functional MRI metrics of treatment response in hepatocellular carcinoma

Preoperative prediction of the microvascular invasion of hepatocellular carcinoma with diffusion-weighted imaging

Evolution of multi-parametric MRI quantitative parameters following transrectal ultrasound-guided biopsy of the prostate

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