Radiologic-pathologic analysis of quantitative 3D tumour enhancement on contrast-enhanced MR imaging: a study of ROI placement

Abstract

Objectives To investigate the influence of region-of-interest (ROI) placement on 3D tumour enhancement [Quantitative European Association for the Study of the Liver (qEASL)] in hepatocellular carcinoma (HCC) patients treated with transcatheter arterial chemoembolization (TACE). Methods Phase 1: 40 HCC patients had nine ROIs placed by one reader using systematic techniques (3 ipsilateral to the lesion, 3 contralateral to the lesion, and 3 dispersed throughout the liver) and qEASL variance was measured. Intra-class correlations were computed. Phase 2: 15 HCC patients with histosegmentation were selected. Six ROIs were systematically placed by AC (3 ROIs ipsilateral and 3 ROIs contralateral to the lesion). Three ROIs were placed by 2 radiologists. qEASL values were compared to histopathology by Pearson’s correlation, linear regression, and median difference. Results Phase 1: The dispersed method (abandoned in phase 2) had low consistency and high variance. Phase 2: qEASL correlated strongly with pathology in systematic methods [Pearson’s correlation coefficient=0.886 (ipsilateral) and 0.727 (contralateral)] and in clinical methods (0.625 and 0.879). However, ipsilateral placement matched best with pathology (median difference: 5.4 %; correlation: 0.89; regression CI: [0.904, 0.1409]). Conclusions qEASL is a robust method with comparable values among tested placements. Ipsilateral placement showed high consistency and better pathological correlation.

Imaging Biomarkers of Tumor Response in Neuroendocrine Liver Metastases Treated with Transarterial Chemoembolization: Can Enhancing Tumor Burden of the Whole Liver Help Predict Patient Survival?

“…Automation reduces inter-reader variability, as confirmed by the high interreader agreement in our study. After liver segmentation, readers simply had to place one ROI in nonmalignant liver tissue, and this is easily implemented in diffuse disease, is time efficient, and has proved sufficient in producing reliable and pathologically accurate results (15,34). Because of the strong association with survival, work-flow efficiency, and histologic accuracy, volumetric ETB may be a more advanced and complete imaging response criterion in patients with NELM treated with TACE.…”

3D Quantitative tumour burden analysis in patients with hepatocellular carcinoma before TACE: comparing single-lesion vs. multi-lesion imaging biomarkers as predictors of patient survival

“…2d). Reader-independent reproducibility of semiautomatic tumour segmentation as well as the radiological-pathological validation of 3D quantitative tumour enhancement analysis has been reported previously [25, 27]. …”

“…Briefly, this was done as follows: The native T1 images were subtracted from the arterial-phase T1 images to remove the background signal. In the next step, a region of interest (ROI) formed by a 1 cm 3 cube was placed in a region of extra-tumoural liver parenchyma of the subtracted data set as a reference [27]. The ROI intensity value was used as a cut-off to identify the volume of hyperenhancing voxels within the segmented tumour volume.…”

Multiparametric MRI of intracranial aneurysms treated with the Woven EndoBridge (WEB): a case of Faraday’s cage?

“…A ROI-based evaluation may always be considered as susceptible to heterogeneities to the measured structure and imaging artifacts 23. This might have caused errors, especially with regard to the smaller aneurysms included in the evaluation.…”