TY - JOUR
T1 - Interobserver agreement of semi-automated and manual measurements of functional MRI metrics of treatment response in hepatocellular carcinoma
AU - Bonekamp, David
AU - Bonekamp, Susanne
AU - Halappa, Vivek Gowdra
AU - Geschwind, Jean-Francois Francois
AU - Eng, John
AU - Corona-Villalobos, Celia Pamela
AU - Pawlik, Timothy M.
AU - Kamel, Ihab R.
PY - 2014/3
Y1 - 2014/3
N2 - 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.
AB - 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.
KW - Cancer treatment response
KW - Functional magnetic resonance imaging
KW - Observer agreement
KW - Reproducibility
KW - Response assessment
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U2 - 10.1016/j.ejrad.2013.11.016
DO - 10.1016/j.ejrad.2013.11.016
M3 - Article
C2 - 24387824
AN - SCOPUS:84893980462
SN - 0720-048X
VL - 83
SP - 487
EP - 496
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 3
ER -