TY - JOUR
T1 - Interreader Variability of Dynamic Contrast-enhanced MRI of Recurrent Glioblastoma
T2 - The multicenter ACRIN 6677/RTOG 0625 study
AU - Barboriak, Daniel P.
AU - Zhang, Zheng
AU - Desai, Pratikkumar
AU - Snyder, Bradley S.
AU - Safriel, Yair
AU - McKinstry, Robert C.
AU - Bokstein, Felix
AU - Sorensen, Gregory
AU - Gilbert, Mark R.
AU - Boxerman, Jerrold L.
N1 - Publisher Copyright:
© RSNA, 2018
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Purpose: To evaluate factors contributing to interreader variation (IRV) in parameters measured at dynamic contrast material–enhanced (DCE) MRI in patients with glioblastoma who were participating in a multicenter trial. Materials and Methods: A total of 18 patients (mean age, 57 years 6 13 [standard deviation]; 10 men) who volunteered for the advanced imaging arm of ACRIN 6677, a substudy of the RTOG 0625 clinical trial for recurrent glioblastoma treatment, underwent analyzable DCE MRI at one of four centers. The 78 imaging studies were analyzed centrally to derive the volume transfer constant (K trans ) for gadolinium between blood plasma and tissue extravascular extracellular space, fractional volume of the extracellular extravascular space (v e ), and initial area under the gadolinium concentration curve (IAUGC). Two independently trained teams consisting of a neuroradiologist and a technologist segmented the enhancing tumor on three-dimensional spoiled gradient-recalled acquisition in the steady-state images. Mean and median parameter values in the enhancing tumor were extracted after registering segmentations to parameter maps. The effect of imaging time relative to treatment, map quality, imager magnet and sequence, average tumor volume, and reader variability in tumor volume on IRV was studied by using intraclass correlation coefficients (ICCs) and linear mixed models. Results: Mean interreader variations (6 standard deviation) (difference as a percentage of the mean) for mean and median IAUGC, mean and median K trans , and median v e were 18% 6 24, 17% 6 23, 27% 6 34, 16% 6 27, and 27% 6 34, respectively. ICCs for these metrics ranged from 0.90 to 1.0 for baseline and from 0.48 to 0.76 for posttreatment examinations. Variability in reader-derived tumor volume was significantly related to IRV for all parameters. Conclusion: Differences in reader tumor segmentations are a significant source of interreader variation for all dynamic contrast-enhanced MRI parameters.
AB - Purpose: To evaluate factors contributing to interreader variation (IRV) in parameters measured at dynamic contrast material–enhanced (DCE) MRI in patients with glioblastoma who were participating in a multicenter trial. Materials and Methods: A total of 18 patients (mean age, 57 years 6 13 [standard deviation]; 10 men) who volunteered for the advanced imaging arm of ACRIN 6677, a substudy of the RTOG 0625 clinical trial for recurrent glioblastoma treatment, underwent analyzable DCE MRI at one of four centers. The 78 imaging studies were analyzed centrally to derive the volume transfer constant (K trans ) for gadolinium between blood plasma and tissue extravascular extracellular space, fractional volume of the extracellular extravascular space (v e ), and initial area under the gadolinium concentration curve (IAUGC). Two independently trained teams consisting of a neuroradiologist and a technologist segmented the enhancing tumor on three-dimensional spoiled gradient-recalled acquisition in the steady-state images. Mean and median parameter values in the enhancing tumor were extracted after registering segmentations to parameter maps. The effect of imaging time relative to treatment, map quality, imager magnet and sequence, average tumor volume, and reader variability in tumor volume on IRV was studied by using intraclass correlation coefficients (ICCs) and linear mixed models. Results: Mean interreader variations (6 standard deviation) (difference as a percentage of the mean) for mean and median IAUGC, mean and median K trans , and median v e were 18% 6 24, 17% 6 23, 27% 6 34, 16% 6 27, and 27% 6 34, respectively. ICCs for these metrics ranged from 0.90 to 1.0 for baseline and from 0.48 to 0.76 for posttreatment examinations. Variability in reader-derived tumor volume was significantly related to IRV for all parameters. Conclusion: Differences in reader tumor segmentations are a significant source of interreader variation for all dynamic contrast-enhanced MRI parameters.
UR - http://www.scopus.com/inward/record.url?scp=85060376018&partnerID=8YFLogxK
U2 - 10.1148/radiol.2019181296
DO - 10.1148/radiol.2019181296
M3 - Article
C2 - 30480488
AN - SCOPUS:85060376018
SN - 0033-8419
VL - 290
SP - 467
EP - 476
JO - Radiology
JF - Radiology
IS - 3
ER -