Measurement of Apparent Diffusion Coefficient Values from Diffusion-Weighted MRI: A Comparison of Manual and Semiautomatic Segmentation Methods

Abstract

Original ArticlePurpose: To compare the interobserver and intraobserver reliability of mean apparent diffusion coefficient (ADC) values using contrast-enhanced (CE) T1 weighted image (WI) and T2WI as structural images between manual and semiautomatic segmentation methods. Materials and Methods: Between January 2011 and May 2013, 28 patients who underwent brain MR with diffusion weighted image (DWI) and were pathologically confirmed as having glioblastoma participated in our study. The ADC values were measured twice in manual and semiautomatic segmentation methods using CE-T1WI and T2WI as structural images to obtain interobserver and intraobserver reliability. Moreover, intraobserver reliabilities of the different segmentation methods were assessed after subgrouping of the patients based on the MR findings. Results: Interobserver and intraobserver reliabilities were high in both manual and semiautomatic segmentation methods on CE-T1WI-based evaluation, while interobserver reliability on T2WI-based evaluation was not high enough to be used in a clinical context. The intraobserver reliability was particularly lower with the T2WI-based semiautomatic segmentation method in the subgroups with involved lobes ≤ 2, with partially demarcated tumor borders, poorly demarcated inner margins of the necrotic portion, and with perilesional edema. Conclusion: Both the manual and semiautomatic segmentation methods on CE-T1WI-based evaluation were clinically acceptable in the measurement of mean ADC values with high interobserver and intraobserver reliabilities.

Dynamic Susceptibility Contrast (DSC) Perfusion MR in the Prediction of Long-Term Survival of Glioblastomas (GBM): Correlation with MGMT Promoter Methylation and 1p/19q Deletions

“…Despite the huge advantage of genetic profiling of GBM for prognostication, genomic information from the part of GBM is inherently inadequate and does not represent the status of the whole GBM, which necessitates the use of a non-invasive procedure for the prognostic prediction of GBM. Segmentation methods using structural images such as T2-weighted images or contrast-enhanced T1weighted images have demonstrated clinical utility in the measurement of apparent diffusion coefficient (ADC) values from glioblastomas (19). Additionally, by using perfusion dynamic susceptibility contrast (DSC) MRI, differential diagnosis between glioblastoma and primary central nervous system (CNS) lymphoma can be achieved with a high diagnostic confidence (20).…”