Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 56, Issue 3, Pages 668-679Publisher
WILEY
DOI: 10.1002/jmri.28093
Keywords
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Funding
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Department of Health and Human Services [HHSN268201000050C]
- National Cancer Institute [U24CA180803]
- National Cancer Institute of the National Institutes of Health [U10CA180820, U10CA180794]
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The study evaluated the repeatability and reproducibility of whole-prostate and focal-lesion ADC assessment in a multi-site setting. Results showed good repeatability and reproducibility for whole-prostate median pixel ADC, and high interreader reliability for focal lesion ADC.
Background Uncertainty regarding the reproducibility of the apparent diffusion coefficient (ADC) hampers the use of quantitative diffusion-weighted imaging (DWI) in evaluation of the prostate with magnetic resonance imaging MRI. The quantitative imaging biomarkers alliance (QIBA) profile for quantitative DWI claims a within-subject coefficient of variation (wCV) for prostate lesion ADC of 0.17. Improved understanding of ADC reproducibility would aid the use of quantitative diffusion in prostate MRI evaluation. Purpose Evaluation of the repeatability (same-day) and reproducibility (multi-day) of whole-prostate and focal-lesion ADC assessment in a multi-site setting. Study Type Prospective multi-institutional. Subjects Twenty-nine males, ages 53 to 80 (median 63) years, following diagnosis of prostate cancer, 10 with focal lesions. Field Strength/Sequence 3T, single-shot spin-echo diffusion-weighted echo-planar sequence with four b-values. Assessment Sites qualified for the study using an ice-water phantom with known ADC. Readers performed DWI analyses at visit 1 (V1) and visit 2 (V2, 2-14 days after V1), where V2 comprised scans before (V2pre) and after (V2post) a coffee-break interval with subject removal and repositioning. A single reader segmented the whole prostate. Two readers separately placed region-of-interests for focal lesions. Statistical Tests Reproducibility and repeatability coefficients for whole prostate and focal lesions derived from median pixel ADC. We estimated the wCV and 95% confidence interval using a variance stabilizing transformation and assessed interreader reliability of focal lesion ADC using the intraclass correlation coefficient (ICC). Results The ADC biases from b(0)-b(600) and b(0)-b(800) phantom scans averaged 1.32% and 1.44%, respectively; mean b-value dependence was 0.188%. Repeatability and reproducibility of whole prostate median pixel ADC both yielded wCVs of 0.033 (N = 29). In 10 subjects with an evaluable focal lesion, the individual reader wCVs were 0.148 and 0.074 (repeatability) and 0.137 and 0.078 (reproducibility). All time points demonstrated good to excellent interreader reliability for focal lesion ADC (ICCV1 = 0.89; ICCV2pre = 0.76; ICCV2post = 0.94). Data Conclusion This study met the QIBA claim for prostate ADC. Test-retest repeatability and multi-day reproducibility were largely equivalent. Interreader reliability for focal lesion ADC was high across time points. Level of Evidence 1 Technical Efficacy Stage 2 TOC Category Pelvis
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