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- Title
Test-retest repeatability and reproducibility of ADC measures by breast DWI: Results from the ACRIN 6698 trial.
- Authors
Newitt, David C.; Zhang, Zheng; Gibbs, Jessica E.; Partridge, Savannah C.; Chenevert, Thomas L.; Rosen, Mark A.; Bolan, Patrick J.; Marques, Helga S.; Aliu, Sheye; Li, Wen; Cimino, Lisa; Joe, Bonnie N.; Umphrey, Heidi; Ojeda‐Fournier, Haydee; Dogan, Basak; Oh, Karen; Abe, Hiroyuki; Drukteinis, Jennifer; Esserman, Laura J.; Hylton, Nola M.
- Abstract
<bold>Background: </bold>Quantitative diffusion-weighted imaging (DWI) MRI is a promising technique for cancer characterization and treatment monitoring. Knowledge of the reproducibility of DWI metrics in breast tumors is necessary to apply DWI as a clinical biomarker.<bold>Purpose: </bold>To evaluate the repeatability and reproducibility of breast tumor apparent diffusion coefficient (ADC) in a multi-institution clinical trial setting, using standardized DWI protocols and quality assurance (QA) procedures.<bold>Study Type: </bold>Prospective.<bold>Subjects: </bold>In all, 89 women from nine institutions undergoing neoadjuvant chemotherapy for invasive breast cancer.<bold>Field Strength/sequence: </bold>DWI was acquired before and after patient repositioning using a four b-value, single-shot echo-planar sequence at 1.5T or 3.0T.<bold>Assessment: </bold>A QA procedure by trained operators assessed artifacts, fat suppression, and signal-to-noise ratio, and determine study analyzability. Mean tumor ADC was measured via manual segmentation of the multislice tumor region referencing DWI and contrast-enhanced images. Twenty cases were evaluated multiple times to assess intra- and interoperator variability. Segmentation similarity was assessed via the Sørenson-Dice similarity coefficient.<bold>Statistical Tests: </bold>Repeatability and reproducibility were evaluated using within-subject coefficient of variation (wCV), intraclass correlation coefficient (ICC), agreement index (AI), and repeatability coefficient (RC). Correlations were measured by Pearson's correlation coefficients.<bold>Results: </bold>In all, 71 cases (80%) passed QA evaluation: 44 at 1.5T, 27 at 3.0T; 60 pretreatment, 11 after 3 weeks of taxane-based treatment. ADC repeatability was excellent: wCV = 4.8% (95% confidence interval [CI] 4.0, 5.7%), ICC = 0.97 (95% CI 0.95, 0.98), AI = 0.83 (95% CI 0.76, 0.87), and RC = 0.16 * 10-3 mm2 /sec (95% CI 0.13, 0.19). The results were similar across field strengths and timepoint subgroups. Reproducibility was excellent: interreader ICC = 0.92 (95% CI 0.80, 0.97) and intrareader ICC = 0.91 (95% CI 0.78, 0.96).<bold>Data Conclusion: </bold>Breast tumor ADC can be measured with excellent repeatability and reproducibility in a multi-institution setting using a standardized protocol and QA procedure. Improvements to DWI image quality could reduce loss of data in clinical trials.<bold>Level Of Evidence: </bold>2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1617-1628.
- Subjects
COMPUTERS in medicine; RESEARCH evaluation; CLINICAL trials; MAGNETIC resonance imaging; CELL receptors; CONTRAST media; DIAGNOSTIC imaging; BREAST; QUALITY control; QUALITY assurance; TUMORS; COMBINED modality therapy; RESEARCH bias; MEDICAL artifacts; BREAST tumors; LONGITUDINAL method
- Publication
Journal of Magnetic Resonance Imaging, 2019, Vol 49, Issue 6, p1617
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.26539