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Fehrenbach U, Xin S, Hartenstein A, Auer TA, Dräger F, Froböse K, Jann H, Mogl M, Amthauer H, Geisel D, Denecke T, Wiedenmann B, Penzkofer T. Automatized Hepatic Tumor Volume Analysis of Neuroendocrine Liver Metastases by Gd-EOB MRI-A Deep-Learning Model to Support Multidisciplinary Cancer Conference Decision-Making. Cancers (Basel) 2021; 13:2726. [PMID: 34072865 PMCID: PMC8199286 DOI: 10.3390/cancers13112726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Rapid quantification of liver metastasis for diagnosis and follow-up is an unmet medical need in patients with secondary liver malignancies. We present a 3D-quantification model of neuroendocrine liver metastases (NELM) using gadoxetic-acid (Gd-EOB)-enhanced MRI as a useful tool for multidisciplinary cancer conferences (MCC). METHODS Manual 3D-segmentations of NELM and livers (149 patients in 278 Gd-EOB MRI scans) were used to train a neural network (U-Net architecture). Clinical usefulness was evaluated in another 33 patients who were discussed in our MCC and received a Gd-EOB MRI both at baseline and follow-up examination (n = 66) over 12 months. Model measurements (NELM volume; hepatic tumor load (HTL)) with corresponding absolute (ΔabsNELM; ΔabsHTL) and relative changes (ΔrelNELM; ΔrelHTL) between baseline and follow-up were compared to MCC decisions (therapy success/failure). RESULTS Internal validation of the model's accuracy showed a high overlap for NELM and livers (Matthew's correlation coefficient (φ): 0.76/0.95, respectively) with higher φ in larger NELM volume (φ = 0.80 vs. 0.71; p = 0.003). External validation confirmed the high accuracy for NELM (φ = 0.86) and livers (φ = 0.96). MCC decisions were significantly differentiated by all response variables (ΔabsNELM; ΔabsHTL; ΔrelNELM; ΔrelHTL) (p < 0.001). ΔrelNELM and ΔrelHTL showed optimal discrimination between therapy success or failure (AUC: 1.000; p < 0.001). CONCLUSION The model shows high accuracy in 3D-quantification of NELM and HTL in Gd-EOB-MRI. The model's measurements correlated well with MCC's evaluation of therapeutic response.
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Affiliation(s)
- Uli Fehrenbach
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
| | - Siyi Xin
- Division of Gastroenterology, Medical Department, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (S.X.); (H.J.); (B.W.)
| | - Alexander Hartenstein
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
- Bayer AG, 13353 Berlin, Germany
| | - Timo Alexander Auer
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
- Berlin Institute of Health, 10178 Berlin, Germany
| | - Franziska Dräger
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
| | - Konrad Froböse
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
| | - Henning Jann
- Division of Gastroenterology, Medical Department, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (S.X.); (H.J.); (B.W.)
| | - Martina Mogl
- Department of Surgery Campus Charité Mitte/Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany;
| | - Dominik Geisel
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Bertram Wiedenmann
- Division of Gastroenterology, Medical Department, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (S.X.); (H.J.); (B.W.)
| | - Tobias Penzkofer
- Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (A.H.); (T.A.A.); (F.D.); (K.F.); (D.G.); (T.P.)
- Berlin Institute of Health, 10178 Berlin, Germany
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