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Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability.

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Date
2017-11
ICR Author
Weller, Alexander
Blackledge, Matthew
deSouza, Nandita
Marsden,
Author
Weller, A
Papoutsaki, MV
Waterton, JC
Chiti, A
Stroobants, S
Kuijer, J
Blackledge, M
Morgan, V
deSouza, NM
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Type
Journal Article
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Abstract
Purpose To determine the test-retest repeatability of Apparent Diffusion Coefficient (ADC) measurements across institutions and MRI vendors, plus investigate the effect of post-processing methodology on measurement precision.Methods Thirty malignant lung lesions >2 cm in size (23 patients) were scanned on two occasions, using echo-planar-Diffusion-Weighted (DW)-MRI to derive whole-tumour ADC (b = 100, 500 and 800smm<sup>-2</sup>). Scanning was performed at 4 institutions (3 MRI vendors). Whole-tumour volumes-of-interest were copied from first visit onto second visit images and from one post-processing platform to an open-source platform, to assess ADC repeatability and cross-platform reproducibility.Results Whole-tumour ADC values ranged from 0.66-1.94x10<sup>-3</sup>mm<sup>2</sup>s<sup>-1</sup> (mean = 1.14). Within-patient coefficient-of-variation (wCV) was 7.1% (95% CI 5.7-9.6%), limits-of-agreement (LoA) -18.0 to 21.9%. Lesions >3 cm had improved repeatability: wCV 3.9% (95% CI 2.9-5.9%); and LoA -10.2 to 11.4%. Variability for lesions <3 cm was 2.46 times higher. ADC reproducibility across different post-processing platforms was excellent: Pearson's R<sup>2</sup> = 0.99; CoV 2.8% (95% CI 2.3-3.4%); and LoA -7.4 to 8.0%.Conclusion A free-breathing DW-MRI protocol for imaging malignant lung tumours achieved satisfactory within-patient repeatability and was robust to changes in post-processing software, justifying its use in multi-centre trials. For response evaluation in individual patients, a change in ADC >21.9% will reflect treatment-related change.Key points • In lung cancer, free-breathing DWI-MRI produces acceptable images with evaluable ADC measurement. • ADC repeatability coefficient-of-variation is 7.1% for lung tumours >2 cm. • ADC repeatability coefficient-of-variation is 3.9% for lung tumours >3 cm. • ADC measurement precision is unaffected by the post-processing software used. • In multicentre trials, 22% increase in ADC indicates positive treatment response.
URI
https://repository.icr.ac.uk/handle/internal/759
DOI
https://doi.org/10.1007/s00330-017-4828-6
Collections
  • Radiotherapy and Imaging
Subject
Humans
Lung Neoplasms
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging
Neoplasm Staging
Tumor Burden
Prospective Studies
Reproducibility of Results
ROC Curve
Adult
Aged
Aged, 80 and over
Middle Aged
Female
Male
Research team
Computational Imaging
Magnetic Resonance
Language
eng
Date accepted
2017-03-20
License start date
2017-11
Citation
European radiology, 2017, 27 (11), pp. 4552 - 4562

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