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Boss MA, Malyarenko D, Partridge S, Obuchowski N, Shukla-Dave A, Winfield JM, Fuller CD, Miller K, Mishra V, Ohliger M, Wilmes LJ, Attariwala R, Andrews T, deSouza NM, Margolis DJ, Chenevert TL, Panzer A. The QIBA Profile for Diffusion-Weighted MRI: Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker. Radiology 2024; 313:e233055. [PMID: 39377680 PMCID: PMC11537247 DOI: 10.1148/radiol.233055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/23/2024] [Accepted: 03/21/2024] [Indexed: 10/09/2024]
Abstract
The apparent diffusion coefficient (ADC) provides a quantitative measure of water mobility that can be used to probe alterations in tissue microstructure due to disease or treatment. Establishment of the accepted level of variance in ADC measurements for each clinical application is critical for its successful implementation. The Diffusion-Weighted Imaging Biomarker Committee of the Quantitative Imaging Biomarkers Alliance (QIBA) has recently advanced the ADC Profile from the consensus to clinically feasible stage for the brain, liver, prostate, and breast. This profile distills multiple studies on ADC repeatability and describes detailed procedures to achieve stated performance claims on an observed ADC change within acceptable confidence limits. In addition to reviewing the current ADC Profile claims, this report has used recent literature to develop proposed updates for establishing metrology benchmarks for mean lesion ADC change that account for measurement variance. Specifically, changes in mean ADC exceeding 8% for brain lesions, 27% for liver lesions, 27% for prostate lesions, and 15% for breast lesions are claimed to represent true changes with 95% confidence. This report also discusses the development of the ADC Profile, highlighting its various stages, and describes the workflow essential to achieving a standardized implementation of advanced quantitative diffusion-weighted MRI in the clinic. The presented QIBA ADC Profile guidelines should enable successful clinical application of ADC as a quantitative imaging biomarker and ensure reproducible ADC measurements that can be used to confidently evaluate longitudinal changes and treatment response for individual patients.
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Affiliation(s)
- Michael A. Boss
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Dariya Malyarenko
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Savannah Partridge
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Nancy Obuchowski
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Amita Shukla-Dave
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Jessica M. Winfield
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Clifton D. Fuller
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Kevin Miller
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Virendra Mishra
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Michael Ohliger
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Lisa J. Wilmes
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Raj Attariwala
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Trevor Andrews
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Nandita M. deSouza
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Daniel J. Margolis
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Thomas L. Chenevert
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
| | - Ariane Panzer
- From the Center for Research and Innovation, American College of
Radiology, 50 S 16th St, Philadelphia, PA 19102 (M.A.B.); Department of
Radiology, University of Michigan, Ann Arbor, Mich (D.M., T.L.C.); Department of
Radiology, University of Washington, Seattle, Wash (S.P.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.);
Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY (A.S.D.); The Institute of Cancer Research, London, UK
(J.M.W., N.M.d.S.); The Royal Marsden NHS Foundation Trust, London, UK (J.M.W.,
N.M.d.S.); Department of Radiation Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Tex (C.D.F.); CaliberMRI, Boulder, Colo (K.M.);
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(V.M.); Department of Radiology and Biomedical Imaging, University of
California, San Francisco, San Francisco, Calif (M.O., L.J.W.); Aim Medical
Imaging, Vancouver, Canada (R.A.); Mallinckrodt Institute of Radiology,
Washington University School of Medicine, St Louis, Mo (T.A.); and Department of
Radiology, Weill Cornell Medical College, New York, NY (D.J.M.)
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Bisgaard ALH, Keesman R, van Lier ALHMW, Coolens C, van Houdt PJ, Tree A, Wetscherek A, Romesser PB, Tyagi N, Lo Russo M, Habrich J, Vesprini D, Lau AZ, Mook S, Chung P, Kerkmeijer LGW, Gouw ZAR, Lorenzen EL, van der Heide UA, Schytte T, Brink C, Mahmood F. Recommendations for improved reproducibility of ADC derivation on behalf of the Elekta MRI-linac consortium image analysis working group. Radiother Oncol 2023; 186:109803. [PMID: 37437609 PMCID: PMC11197850 DOI: 10.1016/j.radonc.2023.109803] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND AND PURPOSE The apparent diffusion coefficient (ADC), a potential imaging biomarker for radiotherapy response, needs to be reproducible before translation into clinical use. The aim of this study was to evaluate the multi-centre delineation- and calculation-related ADC variation and give recommendations to minimize it. MATERIALS AND METHODS Nine centres received identical diffusion-weighted and anatomical magnetic resonance images of different cancerous tumours (adrenal gland, pelvic oligo metastasis, pancreas, and prostate). All centres delineated the gross tumour volume (GTV), clinical target volume (CTV), and viable tumour volume (VTV), and calculated ADCs using both their local calculation methods and each of the following calculation conditions: b-values 0-500 vs. 150-500 s/mm2, region-of-interest (ROI)-based vs. voxel-based calculation, and mean vs. median. ADC variation was assessed using the mean coefficient of variation across delineations (CVD) and calculation methods (CVC). Absolute ADC differences between calculation conditions were evaluated using Friedman's test. Recommendations for ADC calculation were formulated based on observations and discussions within the Elekta MRI-linac consortium image analysis working group. RESULTS The median (range) CVD and CVC were 0.06 (0.02-0.32) and 0.17 (0.08-0.26), respectively. The ADC estimates differed 18% between b-value sets and 4% between ROI/voxel-based calculation (p-values < 0.01). No significant difference was observed between mean and median (p = 0.64). Aligning calculation conditions between centres reduced CVC to 0.04 (0.01-0.16). CVD was comparable between ROI types. CONCLUSION Overall, calculation methods had a larger impact on ADC reproducibility compared to delineation. Based on the results, significant sources of variation were identified, which should be considered when initiating new studies, in particular multi-centre investigations.
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Affiliation(s)
- Anne L H Bisgaard
- Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kløvervænget 19, 5000 Odense, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, 5000 Odense Denmark.
| | - Rick Keesman
- Department of Radiation Oncology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Astrid L H M W van Lier
- Department of Radiotherapy, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX,Utrecht, The Netherlands.
| | - Catherine Coolens
- Department of Medical Physics, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, M5G 2M9 Toronto, ON, Canada.
| | - Petra J van Houdt
- Department of Radiation Oncology, the Netherlands Cancer Institute, Postbus 90203, 1006 BE Amsterdam, The Netherlands.
| | - Alison Tree
- Department of Urology, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT London, UK.
| | - Andreas Wetscherek
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, SM2 5NG London, UK.
| | - Paul B Romesser
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 22, NY 10065, New York, USA.
| | - Neelam Tyagi
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 545 E. 73rd street, NY 10021, New York, USA.
| | - Monica Lo Russo
- Department of Radiation Oncology, University Hospital and Medical Faculty, Eberhard Karls University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
| | - Jonas Habrich
- Section for Biomedical Physics, Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
| | - Danny Vesprini
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5 Toronto, ON, Canada.
| | - Angus Z Lau
- Physical Sciences Platform, Sunnybrook Research Institute. Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, M4N 3M5 Toronto, ON, Canada.
| | - Stella Mook
- Department of Radiotherapy, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX,Utrecht, The Netherlands.
| | - Peter Chung
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network. Department of Radiation Oncology, University of Toronto, 610 University Avenue, M5G 2M9 Toronto, ON, Canada.
| | - Linda G W Kerkmeijer
- Department of Radiation Oncology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Zeno A R Gouw
- Department of Radiation Oncology, the Netherlands Cancer Institute, Postbus 90203, 1006 BE Amsterdam, The Netherlands.
| | - Ebbe L Lorenzen
- Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kløvervænget 19, 5000 Odense, Denmark.
| | - Uulke A van der Heide
- Department of Radiation Oncology, the Netherlands Cancer Institute, Postbus 90203, 1006 BE Amsterdam, The Netherlands.
| | - Tine Schytte
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, 5000 Odense Denmark; Department of Oncology, Odense University Hospital, Kløvervænget 19, 5000 Odense, Denmark.
| | - Carsten Brink
- Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kløvervænget 19, 5000 Odense, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, 5000 Odense Denmark.
| | - Faisal Mahmood
- Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kløvervænget 19, 5000 Odense, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, 5000 Odense Denmark.
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