Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability

Alex Weller, Marianthi Vasiliki Papoutsaki, John C. Waterton, Arturo Chiti, Sigrid Stroobants, Joost Kuijer, Matthew Blackledge, Veronica Morgan, Nandita M. deSouza

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: To determine the test-retest repeatability of Apparent Diffusion Coefficient (ADC) measurements across institutions and MRI vendors, plus investigate the effect of post-processing methodology on measurement precision. Methods: Thirty malignant lung lesions >2 cm in size (23 patients) were scanned on two occasions, using echo-planar-Diffusion-Weighted (DW)-MRI to derive whole-tumour ADC (b = 100, 500 and 800smm-2). Scanning was performed at 4 institutions (3 MRI vendors). Whole-tumour volumes-of-interest were copied from first visit onto second visit images and from one post-processing platform to an open-source platform, to assess ADC repeatability and cross-platform reproducibility. Results: Whole-tumour ADC values ranged from 0.66-1.94x10-3mm2s-1 (mean = 1.14). Within-patient coefficient-of-variation (wCV) was 7.1% (95% CI 5.7–9.6%), limits-of-agreement (LoA) -18.0 to 21.9%. Lesions >3 cm had improved repeatability: wCV 3.9% (95% CI 2.9–5.9%); and LoA -10.2 to 11.4%. Variability for lesions <3 cm was 2.46 times higher. ADC reproducibility across different post-processing platforms was excellent: Pearson’s R2 = 0.99; CoV 2.8% (95% CI 2.3-3.4%); and LoA -7.4 to 8.0%. Conclusion: A free-breathing DW-MRI protocol for imaging malignant lung tumours achieved satisfactory within-patient repeatability and was robust to changes in post-processing software, justifying its use in multi-centre trials. For response evaluation in individual patients, a change in ADC >21.9% will reflect treatment-related change. Key Points: • In lung cancer, free-breathing DWI-MRI produces acceptable images with evaluable ADC measurement. • ADC repeatability coefficient-of-variation is 7.1% for lung tumours >2 cm. • ADC repeatability coefficient-of-variation is 3.9% for lung tumours >3 cm. • ADC measurement precision is unaffected by the post-processing software used. • In multicentre trials, 22% increase in ADC indicates positive treatment response.

Original languageEnglish
Pages (from-to)4552-4562
Number of pages11
JournalEuropean Radiology
Volume27
Issue number11
DOIs
Publication statusPublished - 1 Nov 2017

Cite this

Weller, A., Papoutsaki, M. V., Waterton, J. C., Chiti, A., Stroobants, S., Kuijer, J., ... deSouza, N. M. (2017). Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability. European Radiology, 27(11), 4552-4562. https://doi.org/10.1007/s00330-017-4828-6
Weller, Alex ; Papoutsaki, Marianthi Vasiliki ; Waterton, John C. ; Chiti, Arturo ; Stroobants, Sigrid ; Kuijer, Joost ; Blackledge, Matthew ; Morgan, Veronica ; deSouza, Nandita M. / Diffusion-weighted (DW) MRI in lung cancers : ADC test-retest repeatability. In: European Radiology. 2017 ; Vol. 27, No. 11. pp. 4552-4562.
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title = "Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability",
abstract = "Purpose: To determine the test-retest repeatability of Apparent Diffusion Coefficient (ADC) measurements across institutions and MRI vendors, plus investigate the effect of post-processing methodology on measurement precision. Methods: Thirty malignant lung lesions >2 cm in size (23 patients) were scanned on two occasions, using echo-planar-Diffusion-Weighted (DW)-MRI to derive whole-tumour ADC (b = 100, 500 and 800smm-2). Scanning was performed at 4 institutions (3 MRI vendors). Whole-tumour volumes-of-interest were copied from first visit onto second visit images and from one post-processing platform to an open-source platform, to assess ADC repeatability and cross-platform reproducibility. Results: Whole-tumour ADC values ranged from 0.66-1.94x10-3mm2s-1 (mean = 1.14). Within-patient coefficient-of-variation (wCV) was 7.1{\%} (95{\%} CI 5.7–9.6{\%}), limits-of-agreement (LoA) -18.0 to 21.9{\%}. Lesions >3 cm had improved repeatability: wCV 3.9{\%} (95{\%} CI 2.9–5.9{\%}); and LoA -10.2 to 11.4{\%}. Variability for lesions <3 cm was 2.46 times higher. ADC reproducibility across different post-processing platforms was excellent: Pearson’s R2 = 0.99; CoV 2.8{\%} (95{\%} CI 2.3-3.4{\%}); and LoA -7.4 to 8.0{\%}. Conclusion: A free-breathing DW-MRI protocol for imaging malignant lung tumours achieved satisfactory within-patient repeatability and was robust to changes in post-processing software, justifying its use in multi-centre trials. For response evaluation in individual patients, a change in ADC >21.9{\%} will reflect treatment-related change. Key Points: • In lung cancer, free-breathing DWI-MRI produces acceptable images with evaluable ADC measurement. • ADC repeatability coefficient-of-variation is 7.1{\%} for lung tumours >2 cm. • ADC repeatability coefficient-of-variation is 3.9{\%} for lung tumours >3 cm. • ADC measurement precision is unaffected by the post-processing software used. • In multicentre trials, 22{\%} increase in ADC indicates positive treatment response.",
keywords = "Apparent Diffusion Coefficient (ADC), Diffusion-weighted MRI, Lung Cancer, Repeatability, Reproducibility",
author = "Alex Weller and Papoutsaki, {Marianthi Vasiliki} and Waterton, {John C.} and Arturo Chiti and Sigrid Stroobants and Joost Kuijer and Matthew Blackledge and Veronica Morgan and deSouza, {Nandita M.}",
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Weller, A, Papoutsaki, MV, Waterton, JC, Chiti, A, Stroobants, S, Kuijer, J, Blackledge, M, Morgan, V & deSouza, NM 2017, 'Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability' European Radiology, vol. 27, no. 11, pp. 4552-4562. https://doi.org/10.1007/s00330-017-4828-6

Diffusion-weighted (DW) MRI in lung cancers : ADC test-retest repeatability. / Weller, Alex; Papoutsaki, Marianthi Vasiliki; Waterton, John C.; Chiti, Arturo; Stroobants, Sigrid; Kuijer, Joost; Blackledge, Matthew; Morgan, Veronica; deSouza, Nandita M.

In: European Radiology, Vol. 27, No. 11, 01.11.2017, p. 4552-4562.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Diffusion-weighted (DW) MRI in lung cancers

T2 - ADC test-retest repeatability

AU - Weller, Alex

AU - Papoutsaki, Marianthi Vasiliki

AU - Waterton, John C.

AU - Chiti, Arturo

AU - Stroobants, Sigrid

AU - Kuijer, Joost

AU - Blackledge, Matthew

AU - Morgan, Veronica

AU - deSouza, Nandita M.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Purpose: To determine the test-retest repeatability of Apparent Diffusion Coefficient (ADC) measurements across institutions and MRI vendors, plus investigate the effect of post-processing methodology on measurement precision. Methods: Thirty malignant lung lesions >2 cm in size (23 patients) were scanned on two occasions, using echo-planar-Diffusion-Weighted (DW)-MRI to derive whole-tumour ADC (b = 100, 500 and 800smm-2). Scanning was performed at 4 institutions (3 MRI vendors). Whole-tumour volumes-of-interest were copied from first visit onto second visit images and from one post-processing platform to an open-source platform, to assess ADC repeatability and cross-platform reproducibility. Results: Whole-tumour ADC values ranged from 0.66-1.94x10-3mm2s-1 (mean = 1.14). Within-patient coefficient-of-variation (wCV) was 7.1% (95% CI 5.7–9.6%), limits-of-agreement (LoA) -18.0 to 21.9%. Lesions >3 cm had improved repeatability: wCV 3.9% (95% CI 2.9–5.9%); and LoA -10.2 to 11.4%. Variability for lesions <3 cm was 2.46 times higher. ADC reproducibility across different post-processing platforms was excellent: Pearson’s R2 = 0.99; CoV 2.8% (95% CI 2.3-3.4%); and LoA -7.4 to 8.0%. Conclusion: A free-breathing DW-MRI protocol for imaging malignant lung tumours achieved satisfactory within-patient repeatability and was robust to changes in post-processing software, justifying its use in multi-centre trials. For response evaluation in individual patients, a change in ADC >21.9% will reflect treatment-related change. Key Points: • In lung cancer, free-breathing DWI-MRI produces acceptable images with evaluable ADC measurement. • ADC repeatability coefficient-of-variation is 7.1% for lung tumours >2 cm. • ADC repeatability coefficient-of-variation is 3.9% for lung tumours >3 cm. • ADC measurement precision is unaffected by the post-processing software used. • In multicentre trials, 22% increase in ADC indicates positive treatment response.

AB - Purpose: To determine the test-retest repeatability of Apparent Diffusion Coefficient (ADC) measurements across institutions and MRI vendors, plus investigate the effect of post-processing methodology on measurement precision. Methods: Thirty malignant lung lesions >2 cm in size (23 patients) were scanned on two occasions, using echo-planar-Diffusion-Weighted (DW)-MRI to derive whole-tumour ADC (b = 100, 500 and 800smm-2). Scanning was performed at 4 institutions (3 MRI vendors). Whole-tumour volumes-of-interest were copied from first visit onto second visit images and from one post-processing platform to an open-source platform, to assess ADC repeatability and cross-platform reproducibility. Results: Whole-tumour ADC values ranged from 0.66-1.94x10-3mm2s-1 (mean = 1.14). Within-patient coefficient-of-variation (wCV) was 7.1% (95% CI 5.7–9.6%), limits-of-agreement (LoA) -18.0 to 21.9%. Lesions >3 cm had improved repeatability: wCV 3.9% (95% CI 2.9–5.9%); and LoA -10.2 to 11.4%. Variability for lesions <3 cm was 2.46 times higher. ADC reproducibility across different post-processing platforms was excellent: Pearson’s R2 = 0.99; CoV 2.8% (95% CI 2.3-3.4%); and LoA -7.4 to 8.0%. Conclusion: A free-breathing DW-MRI protocol for imaging malignant lung tumours achieved satisfactory within-patient repeatability and was robust to changes in post-processing software, justifying its use in multi-centre trials. For response evaluation in individual patients, a change in ADC >21.9% will reflect treatment-related change. Key Points: • In lung cancer, free-breathing DWI-MRI produces acceptable images with evaluable ADC measurement. • ADC repeatability coefficient-of-variation is 7.1% for lung tumours >2 cm. • ADC repeatability coefficient-of-variation is 3.9% for lung tumours >3 cm. • ADC measurement precision is unaffected by the post-processing software used. • In multicentre trials, 22% increase in ADC indicates positive treatment response.

KW - Apparent Diffusion Coefficient (ADC)

KW - Diffusion-weighted MRI

KW - Lung Cancer

KW - Repeatability

KW - Reproducibility

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DO - 10.1007/s00330-017-4828-6

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JF - European Radiology

SN - 0938-7994

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Weller A, Papoutsaki MV, Waterton JC, Chiti A, Stroobants S, Kuijer J et al. Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability. European Radiology. 2017 Nov 1;27(11):4552-4562. https://doi.org/10.1007/s00330-017-4828-6