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

Arun Chockalingam, Rafael Duran, Jae Ho Sohn, Rüdiger Schernthaner, Julius Chapiro, Howard Lee, Sonia Sahu, Sonny Nguyen, Jean François Geschwind, Ming De Lin

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


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. Key points: • Ipsilateral and contralateral ROI placement produces high consistency and low variance. • Both ROI placement methods produce qEASL values that correlate well with histopathology. • Ipsilateral ROI placement produces best correlation to pathology along with high consistency.

Original languageEnglish (US)
Pages (from-to)103-113
Number of pages11
JournalEuropean radiology
Issue number1
StatePublished - Jan 1 2016


  • Hepatocellular carcinoma
  • MRI
  • ROI
  • TACE
  • Tumour segmentation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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