Apparent diffusion coefficient (ADC) measurements in pancreatic adenocarcinoma: A preliminary study of the effect of region of interest on ADC values and interobserver variability

C, Ma; Liu, Li; Li, Jing; Wang, Li; Chen, Lu-Guang; Zhang, Yong; Chen, Shi-Yue; Lu, Jianping

doi:10.1002/jmri.25007

Cited by 45 publications

(52 citation statements)

References 39 publications

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“…Larger ROIs [142] and volumetric ROIs [34] demonstrated better reproducibility. Smaller ROIs are also known to suffer from poorer inter-and intra-observer variability [153] . ADC cut-off values are increasingly used in studies to differentiate between normal and cancerous tissues or even between tumour grades.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients,in-vitroandin-vivoreproducibility

Jafar

Parsaï

Miquel

2016

WJR

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There is considerable disparity in the published apparent diffusion coefficient (ADC) values across different anatomies. Institutions are increasingly assessing repeatability and reproducibility of the derived ADC to determine its variation, which could potentially be used as an indicator in determining tumour aggressiveness or assessing tumour response. In this manuscript, a review of selected articles published to date in healthy extracranial body diffusion-weighted magnetic resonance imaging is presented, detailing reported ADC values and discussing their variation across different studies. In total 115 studies were selected including 28 for liver parenchyma, 15 for kidney (renal parenchyma), 14 for spleen, 13 for pancreatic body, 6 for gallbladder, 13 for prostate, 13 for uterus (endometrium, myometrium, cervix) In addition, six phantom studies and thirteen in vivo studies were summarized to compare repeatability and reproducibility of the measured ADC. All selected phantom studies demonstrated lower intra-scanner and inter-scanner variation compared to in vivo studies. Based on the findings of this manuscript, it is recommended that protocols need to be optimised for the body part studied and that system-induced variability must be established using a standardized phantom in any clinical study. Reproducibility of the measured ADC must also be assessed in a volunteer population, as variations are far more significant in vivo compared with phantom studies. Core tip: Diffusion-weighted magnetic resonance imaging was highlighted as a potential cancer imaging biomarker by a team of experts in a report published in 2009. We review the variability of published diffusion values in the major extra-cranial organs and focus on the validation literature, both in vivo and in vitro . A total of 115 studies were selected including for liver parenchyma, kidney, pancreatic body, spleen, gallbladder, prostate, uterus (endometrium, myometrium, cervix) and breast. We also look in detail at the published repeatability and reproducibility studies, both in vivo and in phantoms. A series of recommendations based on our findings are given at the end of this review.Jafar MM, Parsai A, Miquel ME. Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients, in vitro and in vivo reproducibility.

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Section: Discussionmentioning

confidence: 99%

“…(1) Siemens Sonata Ma et al [153] , 2015 Table 4 Estimates of apparent diffusion coefficient values reported in human pancreatic body using a mono-exponential fit Some studies were carried out with more b-values than specified in the following table to compute intravoxel incoherent motion-specific parameters. Jafar MM et al .…”

Section: Prostatementioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients,in-vitroandin-vivoreproducibility

Jafar

Parsaï

Miquel

2016

WJR

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“…During clinical usage, ROI RDSS was the most commonly used ROI selection method for measuring the ADC values. Previous studies indicated that since the ROI RDSS was commonly placed on the area where the tumor showed relative higher signal intensity on DW images, ROI RDSS tended to reflect the most solid, cellular or viable portion of the tumor (1120). However, our study results indicated that inter-reader variability was an major limitation of ROI RDSS .…”

Section: Discussionmentioning

confidence: 99%

“…Previous DWI related studies have mainly utilized three kinds of ROI selection methods to obtain ADC values, including whole tumor ROI, single slice ROI, and reader-defined small sample ROI in selected slices (11). ROI on single or selected slice may lead to inter-reader variability, and does not reflect the tissue heterogeneity (12).…”

Section: Introductionmentioning

confidence: 99%

“…Whole-tumor ROI can overcome this problem, however, it is a time consuming process, which limits its clinical application (12). The influence of ROI selection methods on the ADC measurements has been evaluated in the liver (13), ovaries (14), pancreas (1115), and breast (16). However, to our knowledge, no previous study has addressed the influence of the three different ROI selection methods on the ADC measurements, and their diagnostic abilities for differentiating benign from malignant orbital tumors.…”

Section: Introductionmentioning

confidence: 99%

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Diffusion Weighted Imaging for Differentiating Benign from Malignant Orbital Tumors: Diagnostic Performance of the Apparent Diffusion Coefficient Based on Region of Interest Selection Method

et al. 2016

Korean J Radiol

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ObjectiveTo evaluate the differences in the apparent diffusion coefficient (ADC) measurements based on three different region of interest (ROI) selection methods, and compare their diagnostic performance in differentiating benign from malignant orbital tumors.Materials and MethodsDiffusion-weighted imaging data of sixty-four patients with orbital tumors (33 benign and 31 malignant) were retrospectively analyzed. Two readers independently measured the ADC values using three different ROIs selection methods including whole-tumor (WT), single-slice (SS), and reader-defined small sample (RDSS). The differences of ADC values (ADC-ROIWT, ADC-ROISS, and ADC-ROIRDSS) between benign and malignant group were compared using unpaired t test. Receiver operating characteristic curve was used to determine and compare their diagnostic ability. The ADC measurement time was compared using ANOVA analysis and the measurement reproducibility was assessed using Bland-Altman method and intra-class correlation coefficient (ICC).ResultsMalignant group showed significantly lower ADC-ROIWT, ADC-ROISS, and ADC-ROIRDSS than benign group (all p < 0.05). The areas under the curve showed no significant difference when using ADC-ROIWT, ADC-ROISS, and ADC-ROIRDSS as differentiating index, respectively (all p > 0.05). The ROISS and ROIRDSS required comparable measurement time (p > 0.05), while significantly shorter than ROIWT (p < 0.05). The ROISS showed the best reproducibility (mean difference ± limits of agreement between two readers were 0.022 [-0.080–0.123] × 10-3 mm2/s; ICC, 0.997) among three ROI methods.ConclusionApparent diffusion coefficient values based on the three different ROI selection methods can help to differentiate benign from malignant orbital tumors. The results of measurement time, reproducibility and diagnostic ability suggest that the ROISS method are potentially useful for clinical practice.

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Importance of different region‐of‐interest protocols for the apparent diffusion coefficient measurement of tumors in diffusion‐weighted magnetic resonance imaging

Priola

Veltri

Priola

2016

Magnetic Resonance Imaging

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Apparent diffusion coefficient (ADC) measurements in pancreatic adenocarcinoma: A preliminary study of the effect of region of interest on ADC values and interobserver variability

Abstract: The ROI method had a considerable influence on both the minimum and mean ADC values and the interobserver variability in PDAC. The worst interobserver variability was observed for both the minimum and mean ADCs derived from small solid-sample ROI.

Cited by 45 publications

References 39 publications

Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients,in-vitroandin-vivoreproducibility

Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients,in-vitroandin-vivoreproducibility

Diffusion Weighted Imaging for Differentiating Benign from Malignant Orbital Tumors: Diagnostic Performance of the Apparent Diffusion Coefficient Based on Region of Interest Selection Method

Importance of different region‐of‐interest protocols for the apparent diffusion coefficient measurement of tumors in diffusion‐weighted magnetic resonance imaging

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