Moreau B, Iannessi A, Hoog C, Beaumont H. How reliable are ADC measurements? A phantom and clinical study of cervical lymph nodes.
Eur Radiol 2018;
28:3362-3371. [PMID:
29476218 PMCID:
PMC6028847 DOI:
10.1007/s00330-017-5265-2]
[Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/11/2017] [Accepted: 12/20/2017] [Indexed: 12/11/2022]
Abstract
Objective
To assess the reliability of ADC measurements in vitro and in cervical lymph nodes of healthy volunteers.
Methods
We used a GE 1.5 T MRI scanner and a first ice-water phantom according to recommendations released by the Quantitative Imaging Biomarker Alliance (QIBA) for assessing ADC against reference values. We analysed the target size effect by using a second phantom made of six inserted spheres with diameters ranging from 10 to 37 mm. Thirteen healthy volunteers were also scanned to assess the inter- and intra-observer reproducibility of volumetric ADC measurements of cervical lymph nodes.
Results
On the ice-water phantom, the error in ADC measurements was less than 4.3 %. The spatial bias due to the non-linearity of gradient fields was found to be 24 % at 8 cm from the isocentre. ADC measure reliability decreased when addressing small targets due to partial volume effects (up to 12.8 %). The mean ADC value of cervical lymph nodes was 0.87.10-3 ± 0.12.10-3 mm2/s with a good intra-observer reliability. Inter-observer reproducibility featured a bias of -5.5 % due to segmentation issues.
Conclusion
ADC is a potentially important imaging biomarker in oncology; however, variability issues preclude its broader adoption. Reliable use of ADC requires technical advances and systematic quality control.
Key Points
• ADC is a promising quantitative imaging biomarker.
• ADC has a fair inter-reader variability and good intra-reader variability.
• Partial volume effect, post-processing software and non-linearity of scanners are limiting factors.
• No threshold values for detecting cervical lymph node malignancy can be drawn.
Electronic supplementary material
The online version of this article (10.1007/s00330-017-5265-2) contains supplementary material, which is available to authorized users.
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