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Repeatability and reproducibility of ADC measurements

Tijdschriftbijdrage - Tijdschriftartikel

Ondertitel:a prospective multicenter whole-body-MRI study

OBJECTIVES: Multicenter oncology trials increasingly include MRI examinations with apparent diffusion coefficient (ADC) quantification for lesion characterization and follow-up. However, the repeatability and reproducibility (R&R) limits above which a true change in ADC can be considered relevant are poorly defined. This study assessed these limits in a standardized whole-body (WB)-MRI protocol.

METHODS: A prospective, multicenter study was performed at three centers equipped with the same 3.0-T scanners to test a WB-MRI protocol including diffusion-weighted imaging (DWI). Eight healthy volunteers per center were enrolled to undergo test and retest examinations in the same center and a third examination in another center. ADC variability was assessed in multiple organs by two readers using two-way mixed ANOVA, Bland-Altman plots, coefficient of variation (CoV), and the upper limit of the 95% CI on repeatability (RC) and reproducibility (RDC) coefficients.

RESULTS: CoV of ADC was not influenced by other factors (center, reader) than the organ. Based on the upper limit of the 95% CI on RC and RDC (from both readers), a change in ADC in an individual patient must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central and peripheral zones of the prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be significant.

CONCLUSIONS: This study proposes R&R limits above which ADC changes can be considered as a reliable quantitative endpoint to assess disease or treatment-related changes in the tissue microstructure in the setting of multicenter WB-MRI trials.

KEY POINTS: • The present study showed the range of R&R of ADC in WB-MRI that may be achieved in a multicenter framework when a standardized protocol is deployed. • R&R was not influenced by the site of acquisition of DW images. • Clinically significant changes in ADC measured in a multicenter WB-MRI protocol performed with the same type of MRI scanner must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central zone and peripheral zone of prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be detected with a 95% confidence level.

Tijdschrift: Eur Radiol
ISSN: 0938-7994
Issue: 7
Volume: 31
Pagina's: 4514-4527
Jaar van publicatie:2021
Trefwoorden:Cancer, Diffusion magnetic resonance imaging, Disease progression, Reproducibility of results, Whole-body imaging
  • ORCID: /0000-0001-5714-3254/work/96406668
  • ORCID: /0000-0002-3601-3212/work/96406245
  • ORCID: /0000-0003-3345-4431/work/96405718
  • ORCID: /0000-0002-5424-6300/work/96405367
  • Scopus Id: 85099032937
  • WoS Id: 000605578600026
  • DOI: https://doi.org/10.1007/s00330-020-07522-0
BOF-keylabel:ja
IOF-keylabel:ja
BOF-publication weight:3
Auteurs:Regional
Authors from:Government, Higher Education
Toegankelijkheid:Closed