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- Title
MRI Follow-up of Astrocytoma: Automated Coregistration and Color-Coding of FLAIR Sequences Improves Diagnostic Accuracy With Comparable Reading Time.
- Authors
Lennartz, Simon; Zopfs, David; Nobis, Anne; Paquet, Stefanie; Hoyer, Ulrike Cornelia Isabel; Zäske, Charlotte; Goertz, Lukas; Kabbasch, Christoph; Laukamp, Kai Roman; Große Hokamp, Nils; Galldiks, Norbert; Borggrefe, Jan
- Abstract
<bold>Background: </bold>MRI follow-up is widely used for longitudinal assessment of astrocytoma, yet reading can be tedious and error-prone, in particular when changes are subtle.<bold>Purpose/hypothesis: </bold>To determine the effect of automated, color-coded coregistration (AC) of fluid attenuated inversion recovery (FLAIR) sequences on diagnostic accuracy, certainty, and reading time compared to conventional follow-up MRI assessment of astrocytoma patients.<bold>Study Type: </bold>Retrospective.<bold>Population: </bold>In all, 41 patients with neuropathologically confirmed astrocytoma.<bold>Field Strength/sequence: </bold>1.0-3.0T/FLAIR ASSESSMENT: The presence or absence of tumor progression was determined based on FLAIR sequences, contrast-enhanced T1 sequences, and clinical data. Three radiologists assessed 47 MRI study pairs in a conventional reading (CR) and in a second reading supported by AC after 6 weeks. Readers determined the presence/absence of tumor progression and indicated diagnostic certainty on a 5-point Likert scale. Reading time was recorded by an independent assessor.<bold>Statistical Tests: </bold>The Wilcoxon test was used to assess reading time and diagnostic certainty. Differences in diagnostic accuracy, sensitivity, and specificity were analyzed with the McNemar mid-p test.<bold>Results: </bold>Readers attained significantly higher overall sensitivity (0.86 vs. 0.75; P < 0.05) and diagnostic accuracy (0.84 vs. 0.73; P < 0.05) for detection of progressive nonenhancing tumor burden when using AC compared to CR. There was a strong trend towards higher specificity within the AC-augmented reading, yet without statistical significance (0.83 vs. 0.71; P = 0.08). Sensitivity for unequivocal disease progression was similarly high in both approaches (AC: 0.94, CR: 0.92), while for marginal disease progressions, it was significantly higher in AC (AC: 0.78, CR: 0.58; P < 0.05). Reading time including application loading time was comparable (AC: 38.1 ± 16.8 sec, CR: 36.0 ± 18.9 s; P = 0.25).<bold>Data Conclusion: </bold>Compared to CR, AC improves comparison of FLAIR signal hyperintensity at MRI follow-up of astrocytoma patients, allowing for a significantly higher diagnostic accuracy, particularly for subtle disease progression at a comparable reading time.<bold>Evidence Level: </bold>3 TECHNICAL EFFICACY STAGE: 6 J. Magn. Reson. Imaging 2020;52:1197-1206.
- Subjects
ASTROCYTOMAS; LIKERT scale; CANCER invasiveness; READING; DISEASE progression; RESEARCH; RESEARCH methodology; CONTRAST media; GLIOMAS; MAGNETIC resonance imaging; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; RESEARCH funding; LONGITUDINAL method
- Publication
Journal of Magnetic Resonance Imaging, 2020, Vol 52, Issue 4, p1197
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.27136